NPIMap

Organization Active NPI

KMG Pharmacy LLC

  • Long Term Care Pharmacy
  • Trotwood, OH
National Provider Identifier
1124856703
Registry record updated Jul 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
Legal business name
KMG PHARMACY LLC
Practice address
846 E Main St
Trotwood, OH 45426-2911
Phone
(937) 529-4433
Fax
(937) 715-4447
NPI assigned
Jul 24, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Mahmoud Jamil Shaltaf, RPHNPI 1578861944
Title
Pic/Owner
Phone
(708) 589-5668

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Long Term Care Pharmacy 3336L0003X Primary

Addresses

Primary practice location

846 E Main St
Trotwood, OH 45426-2911

Mailing address

846 E Main St
Trotwood, OH 45426-2911
Phone (937) 529-4433

National Provider Directory

National Provider Directory

Locations

846 E Main St
Trotwood, OH 45426
Phone (937) 529-4433

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1721779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721779200000",
    "number": "1124856703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "846 E MAIN ST",
            "city": "TROTWOOD",
            "state": "OH",
            "postal_code": "454262911",
            "telephone_number": "937-529-4433",
            "fax_number": "937-715-4447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "846 E MAIN ST",
            "city": "TROTWOOD",
            "state": "OH",
            "postal_code": "454262911",
            "telephone_number": "937-529-4433",
            "fax_number": "937-715-4447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KMG PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-24",
        "last_updated": "2024-07-24",
        "certification_date": "2024-07-24",
        "status": "A",
        "authorized_official_last_name": "SHALTAF",
        "authorized_official_first_name": "MAHMOUD",
        "authorized_official_middle_name": "JAMIL",
        "authorized_official_title_or_position": "PIC/OWNER",
        "authorized_official_telephone_number": "708-589-5668",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Trotwood, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.