Koach3 Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

5301009312 Issued in MI

Legal business name

KOACH3 INC

Practice address

9600 Dexter Ave
Detroit, MI 48206-1816

Phone

(313) 870-9201

Fax

(313) 870-9207

NPI assigned

May 4, 2010

Organization subpart

No

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

Authorized official

Name

Komal Acharya

Title

President

Phone

(313) 870-9201

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Prestige Pharmacy Doing business as

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

{
    "created_epoch": "1272931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1308009600000",
    "number": "1306164140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9600 DEXTER AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482061816",
            "telephone_number": "313-870-9201",
            "fax_number": "313-870-9207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9600 DEXTER AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482061816",
            "telephone_number": "313-870-9201",
            "fax_number": "313-870-9207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KOACH3 INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-04",
        "last_updated": "2011-06-14",
        "status": "A",
        "authorized_official_last_name": "ACHARYA",
        "authorized_official_first_name": "KOMAL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "313-870-9201"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MI",
            "license": "5301009312",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "2374039",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Prestige Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Faliscia Charice Knuckles
• Colin Christian Knudsen, CRNA
• Nancy Knuth, CNP
• Thomas Knuth, M.D.
• Alvin Bryant Ko, MD
• Dwede Kobbah, NP
• Fatimah Kobeissi, PHARMD
• Malak Kobeissi
• Lester J. Kobylak, M.D.
• Mary Elizabeth Kocenda, ACNP

• Community/Retail Pharmacy in Detroit, MI
• Providers in Detroit, MI by specialty
• Community/Retail Pharmacy in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2011; 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.