Kwabena Adarkwah, PHARMACIST
Individual provider Active NPI Pharmacist · Fresno, CA
NPI 1114580974 · NPPES record last updated Apr 17, 2019
Key facts
- NPI
- 1114580974
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 80408 (CA)
- Practice address
- 1210 N Blackstone Ave
Fresno, CA 93703-3606 - Phone
- (559) 445-0694
- NPI assigned
- Apr 17, 2019
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 80408 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Thrifty Payless Inc | Past | Accepting new patients | |
| Thrifty Payless Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 80408 | CA | Yes |
Addresses
Primary practice location
1210 N Blackstone Ave
Fresno, CA 93703-3606
Mailing address
1210 N Blackstone Ave
Fresno, CA 93703-3606
Phone (559) 445-0694
Other providers in Fresno, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 17, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.