Individual provider Active NPI

Enoch Chia Han Ko

  • Pharmacist
  • Madison, AL
National Provider Identifier
1326414467
Registry record updated Aug 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
18912 Issued in AL
Practice address
12010 County Line Rd
Apt 1208
Madison, AL 35756-2000
Phone
(256) 230-6345
NPI assigned
Aug 12, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 12, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 18912 AL Primary

Addresses

Primary practice location

12010 County Line Rd
Apt 1208
Madison, AL 35756-2000

Mailing address

12010 County Line Rd
Madison, AL 35756-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
18912ALMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co Past Accepting new patients
Walgreen Co PastSince Apr 17, 2022 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1439337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439337600000",
    "number": "1326414467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12010 COUNTY LINE RD",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357562000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12010 COUNTY LINE RD",
            "address_2": "APT 1208",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357562000",
            "telephone_number": "256-230-6345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KO",
        "first_name": "ENOCH",
        "middle_name": "CHIA HAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-08-12",
        "last_updated": "2015-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AL",
            "license": "18912",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2015; 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.