Kent Island Pharmacy, LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

KENT ISLAND PHARMACY, LLC

Practice address

382 Thompson Creek Mall
Stevensville, MD 21666-2593

Phone

(609) 516-8591

NPI assigned

Oct 9, 2019

Organization subpart

No

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

Authorized official

Name

Rajendra Prasad Kamma

Title

Member

Phone

(609) 516-8591

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1570579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1570579200000",
    "number": "1184266355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3820 MOUNATIN ROAD",
            "address_2": "UNIT G",
            "city": "PASADENA",
            "state": "MD",
            "postal_code": "21122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "382 THOMPSON CREEK MALL",
            "city": "STEVENSVILLE",
            "state": "MD",
            "postal_code": "216662593",
            "telephone_number": "609-516-8591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENT ISLAND PHARMACY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-09",
        "last_updated": "2019-10-09",
        "status": "A",
        "authorized_official_last_name": "KAMMA",
        "authorized_official_first_name": "RAJENDRA",
        "authorized_official_middle_name": "PRASAD",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "609-516-8591"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Demetrios J Kalliongis, MD
• Andrea R Kane Frank, MS, LCPC
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• Dudley Katz, DDS
• Jennifer Lynn Kelley, M.A., B.C.B.A.
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• Jay S Kimbro, RPSGT
• Kinera Foundation Inc
• Kinera Foundation, Inc

• Community/Retail Pharmacy in Stevensville, MD
• Providers in Stevensville, MD by specialty
• Community/Retail Pharmacy in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2019; 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.