Kevin Trenouth Kellow, PHARMD
Individual provider Active NPI Pharmacist · Springhill, LA
NPI 1457773145 · NPPES record last updated Jan 14, 2014
Key facts
- NPI
- 1457773145
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 019095 (LA)
- Practice address
- 1920 S Arkansas St
Springhill, LA 71075-4320 - Phone
- (318) 539-3500
- Fax
- (318) 539-2522
- NPI assigned
- Jan 14, 2014
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019095 | LA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wal-Mart Stores East, LP | Past | Accepting new patients | |
| Wal-Mart Stores East LP | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 019095 | LA | Yes |
Addresses
Primary practice location
1920 S Arkansas St
Springhill, LA 71075-4320
Mailing address
1920 S Arkansas St
Springhill, LA 71075-4320
Phone (318) 539-3500
Other providers in Springhill, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 14, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.