Kondo Enterprises Corp

Primary specialty

PharmacistTaxonomy code 183500000X

License

PD08105 Issued in AR

Legal business name

KONDO ENTERPRISES CORP

Doing business as

Kondo Drug Store

Practice address

11321 Interstate 30
Suite 102
Little Rock, AR 72209-7040

Phone

(501) 353-2136

Fax

(501) 353-2594

NPI assigned

Feb 9, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Yao Kondo, P.D.

Title

Pharmacist, President, Ceo

Phone

(501) 353-2136

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• KONDO DRUG STORE Doing business as

Locations

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1335484800000",
    "number": "1184765315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11321 INTERSTATE 30",
            "address_2": "SUITE 102",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722097040",
            "telephone_number": "501-353-2136",
            "fax_number": "501-353-2594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11321 INTERSTATE 30",
            "address_2": "SUITE 102",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722097040",
            "telephone_number": "501-353-2136",
            "fax_number": "501-353-2594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KONDO ENTERPRISES CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-09",
        "last_updated": "2012-04-27",
        "status": "A",
        "authorized_official_last_name": "KONDO",
        "authorized_official_first_name": "YAO",
        "authorized_official_title_or_position": "PHARMACIST, PRESIDENT, CEO",
        "authorized_official_telephone_number": "501-353-2136",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "P.D."
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist",
            "state": "AR",
            "license": "PD08105",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "0418649",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "126154407",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "KONDO DRUG STORE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Amy Lynn Kooms, M.A., CCC-SLP
• Laura K Koon

• Pharmacist in Little Rock, AR
• Providers in Little Rock, AR by specialty
• Pharmacist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2012; 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.