Active NPI
West Kingman Pharmacy, LLC
- Long Term Care Pharmacy
- Kingman, AZ
National Provider Identifier
1245357706
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Long Term Care Pharmacy
- Legal business name
- WEST KINGMAN PHARMACY, LLC
- Practice address
- 3135 N Stockton Hill Rd
Kingman, AZ 86401 - Phone
- (928) 377-1350
- NPI assigned
- Mar 22, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Kassie Lynn Villa, CPHT
- Title
- Pharmacy Manager
- Phone
- (928) 377-1350
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic Pharmacy | 3336C0002X | 4696 | AZ | |
| Long Term Care Pharmacy | 3336L0003X | Primary |
Addresses
Primary practice location
3135 N Stockton Hill Rd
Kingman, AZ 86401
Mailing address
1099 Sunrise Ave
Kingman, AZ 86401-6825
Phone (928) 718-4852
Other practice location 1
3505 Western Ave
Kingman, AZ 86409-3011
Phone (928) 681-5599
National Provider Directory
National Provider Directory- Tax ID family
- West Kingman Pharmacy LLC
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Community/Retail Pharmacy
- Kingman, AZ
- NPI 1760878821
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174521600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1583884800000",
"number": "1245357706",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1099 SUNRISE AVE",
"city": "KINGMAN",
"state": "AZ",
"postal_code": "864016825",
"telephone_number": "928-718-4852",
"fax_number": "928-718-4856"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3135 N STOCKTON HILL RD",
"city": "KINGMAN",
"state": "AZ",
"postal_code": "86401",
"telephone_number": "928-377-1350"
}
],
"practiceLocations": [
{
"address_1": "3505 Western Ave",
"address_purpose": "LOCATION",
"city": "Kingman",
"state": "AZ",
"postal_code": "864093011",
"country_code": "US",
"telephone_number": "928-681-5599",
"fax_number": "928-718-4856",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "WEST KINGMAN PHARMACY, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2007-03-22",
"last_updated": "2020-03-11",
"certification_date": "2020-03-11",
"status": "A",
"authorized_official_last_name": "VILLA",
"authorized_official_first_name": "KASSIE",
"authorized_official_middle_name": "LYNN",
"authorized_official_title_or_position": "PHARMACY MANAGER",
"authorized_official_telephone_number": "928-377-1350",
"authorized_official_credential": "CPHT"
},
"taxonomies": [
{
"code": "3336C0002X",
"taxonomy_group": "",
"desc": "Pharmacy, Clinic Pharmacy",
"state": "AZ",
"license": "4696",
"primary": false
},
{
"code": "3336L0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Long Term Care Pharmacy",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kingman, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.