Robert Kevorkian

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PCY0000856 Issued in CT

Legal business name

ROBERT KEVORKIAN

Doing business as

Simsbury Pharmacy

Practice address

1418 Hopmeadow St
Simsbury, CT 06070-1410

Phone

(860) 658-4489

Fax

(860) 651-7663

NPI assigned

Sep 20, 2006

Last updated

Jan 23, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Robert Kevorkian, RPH PHD

Title

Owner

Phone

(860) 658-4489

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• SIMSBURY PHARMACY Doing business as

Locations

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1485129600000",
    "number": "1235236431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1418 HOPMEADOW ST",
            "city": "SIMSBURY",
            "state": "CT",
            "postal_code": "060701410",
            "telephone_number": "860-658-4489",
            "fax_number": "860-651-7663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1418 HOPMEADOW ST",
            "city": "SIMSBURY",
            "state": "CT",
            "postal_code": "060701410",
            "telephone_number": "860-658-4489",
            "fax_number": "860-651-7663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT KEVORKIAN",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2017-01-23",
        "status": "A",
        "authorized_official_last_name": "KEVORKIAN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "860-658-4489",
        "authorized_official_credential": "RPH PHD"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CT",
            "license": "PCY0000856",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004030763",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "1998104",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SIMSBURY PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Simsbury, CT
• Providers in Simsbury, CT by specialty
• Community/Retail Pharmacy in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2017; 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.