Active NPI
Kendall Kori Rouleau
- Pharmacist
- Morgantown, WV
National Provider Identifier
1437605227
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RP450603
- Practice address
- 5001 University Towne Center Dr
Morgantown, WV 26501-2267 - Phone
- (304) 599-5581
- NPI assigned
- Aug 31, 2016
- Sex
- Female
- Sole proprietor
- No
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 | RP450603 | PA | Primary |
Addresses
Primary practice location
5001 University Towne Center Dr
Morgantown, WV 26501-2267
Mailing address
5001 University Towne Center Dr
Morgantown, WV 26501-2267
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
| License | State | Type | Specialty |
|---|---|---|---|
| RP450603 | PA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Carolina CVS Pharmacy LLC | Past | Accepting new patients | |
| West Virginia CVS Pharmacy LLC | Past | 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.
-
dba Target Pharmacy
- Community/Retail Pharmacy
- Morgantown, WV
- NPI 1124041421
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1472601600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1472601600000",
"number": "1437605227",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5001 UNIVERSITY TOWNE CENTER DR",
"city": "MORGANTOWN",
"state": "WV",
"postal_code": "265012267"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5001 UNIVERSITY TOWNE CENTER DR",
"city": "MORGANTOWN",
"state": "WV",
"postal_code": "265012267",
"telephone_number": "304-599-5581"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROULEAU",
"first_name": "KENDALL",
"middle_name": "KORI",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-08-31",
"last_updated": "2016-08-31",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "PA",
"license": "RP450603",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Morgantown, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.