Organization Active NPI

KC Pharmacy Corporation

  • Community/Retail Pharmacy
  • San Jose, CA
National Provider Identifier
1508403841
Registry record updated Dec 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
KC PHARMACY CORPORATION
Practice address
2060 Aborn Rd Ste 150B
San Jose, CA 95121-1587
Phone
(408) 400-4755
Fax
(408) 868-2326
NPI assigned
Dec 5, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2019

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

Authorized official

Name
Dr. Nhuong Kich Le, PHARM DNPI 1477110153
Title
Owner, President, Ceo
Phone
(602) 596-9958

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

2060 Aborn Rd Ste 150B
San Jose, CA 95121-1587

Mailing address

2060 Aborn Rd Ste 150B
San Jose, CA 95121-1587
Phone (408) 400-4755

Other identifiers 1

IdentifierTypeStateIssuer
57447OtherCABOARD OF PHARMACY LICENSE

Other names 1

  • KC Pharmacy Doing business as

National Provider Directory

National Provider Directory

Locations

2060 Aborn Rd
Ste 150B
San Jose, CA 95121
Phone (408) 400-4755

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1575504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576281600000",
    "number": "1508403841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2060 ABORN RD STE 150B",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951211587",
            "telephone_number": "408-400-4755",
            "fax_number": "408-868-2326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2060 ABORN RD STE 150B",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951211587",
            "telephone_number": "408-400-4755",
            "fax_number": "408-868-2326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KC PHARMACY CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-05",
        "last_updated": "2019-12-14",
        "certification_date": "2019-12-14",
        "status": "A",
        "authorized_official_last_name": "LE",
        "authorized_official_first_name": "NHUONG",
        "authorized_official_middle_name": "KICH",
        "authorized_official_title_or_position": "OWNER, PRESIDENT, CEO",
        "authorized_official_telephone_number": "602-596-9958",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARM D"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF PHARMACY LICENSE",
            "identifier": "57447",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "KC Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "KC Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2019; 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.