Active NPI
Krilurk Chanvitayapongs, R.PH.
- Pharmacist
- Caruthersville, MO
National Provider Identifier
1366512287
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 041227
- Practice address
- 2709 South Ward
Caruthersville, MO 63830 - Phone
- (800) 626-6934
- Fax
- (573) 333-2843
- NPI assigned
- Nov 8, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 041227 | MO | Primary |
Addresses
Primary practice location
2709 South Ward
Caruthersville, MO 63830
Mailing address
2709 South Ward
Caruthersville, MO 63830
Phone (800) 626-6934
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
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 041227 | MO | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162944000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1366512287",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2709 SOUTH WARD",
"city": "CARUTHERSVILLE",
"state": "MO",
"postal_code": "63830",
"telephone_number": "800-626-6934",
"fax_number": "573-333-2843"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2709 SOUTH WARD",
"city": "CARUTHERSVILLE",
"state": "MO",
"postal_code": "63830",
"telephone_number": "800-626-6934",
"fax_number": "573-333-2843"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHANVITAYAPONGS",
"first_name": "KRILURK",
"credential": "R.PH.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-08",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MO",
"license": "041227",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Caruthersville, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.