KD Pharmacy, Inc.

Primary specialty

PharmacyTaxonomy code 333600000X

License

5301007358 Issued in MI

Legal business name

KD PHARMACY, INC.

Practice address

3130 Gratiot Ave
Detroit, MI 48207-2283

Phone

(313) 924-0092

Fax

(313) 924-0118

NPI assigned

Aug 26, 2005

Organization subpart

No

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

Authorized official

Name

Mr. John Dejongh

Title

President of Operations

Phone

(248) 540-8066

Specialties & licenses 1

Addresses

Other identifiers 3

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

{
    "created_epoch": "1125014400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1234396800000",
    "number": "1184617912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2520 INDUSTRIAL ROW DR",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480847035",
            "telephone_number": "248-540-8066",
            "fax_number": "248-540-0112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3130 GRATIOT AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482072283",
            "telephone_number": "313-924-0092",
            "fax_number": "313-924-0118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KD PHARMACY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-26",
        "last_updated": "2009-02-12",
        "status": "A",
        "authorized_official_last_name": "DEJONGH",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT OF OPERATIONS",
        "authorized_official_telephone_number": "248-540-8066",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "MI",
            "license": "5301007358",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2362616",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1184617912",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "2362616",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shadman Seraj Kazi, D.O.
• Ali Rashed Kazmi
• Narjis Seyyed Kazmi, M.D
• Roshni S Kazmi
• Sara Renee Kazyak, MD, MS
• KD Pharmacy, Inc.
• Brent Keaner, D.O.
• Michaela Emily Kearney, MD
• Phyllis E Kearney, MA, LLPC
• Katie Marie Kearns

• Pharmacy in Detroit, MI
• Providers in Detroit, MI by specialty
• Pharmacy in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2009; 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.