Justin Hafedh Kakos

Primary specialty

Pharmacy TechnicianTaxonomy code 183700000X

License

5303010794 Issued in MI

Practice address

37399 6 Mile Rd
Livonia, MI 48152-2775

Phone

(734) 464-7960

NPI assigned

Sep 22, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Perry Drug Stores Inc and Subsidiaries

  • Community/Retail Pharmacy
  • Livonia, MI
  • NPI 1013927573
  NPD (past)

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

{
    "created_epoch": "1632268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632268800000",
    "number": "1487325148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37399 6 MILE RD",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481522775",
            "telephone_number": "734-464-7960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37399 6 MILE RD",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481522775",
            "telephone_number": "734-464-7960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAKOS",
        "first_name": "JUSTIN",
        "middle_name": "HAFEDH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-09-22",
        "last_updated": "2021-09-22",
        "certification_date": "2021-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183700000X",
            "taxonomy_group": "",
            "desc": "Pharmacy Technician",
            "state": "MI",
            "license": "5303010794",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anjali Kailash Chhabria
• Michael Kain
• Allen Kaiserman, CCP
• Rebecca Watson Himm Kajtar, D.D.S.
• Amanda Kako
• Anna Kalbfell, M.D.
• Sharon Michelle Kalil
• Galina Kalinkova Brown
• Brad Kalleberg, RT (R)
• Bruce Kallou, DPM

• Pharmacy Technician in Livonia, MI
• Providers in Livonia, MI by specialty
• Pharmacy Technician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2021; 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.