KD Pharmacy, Inc.

Primary specialty

PharmacyTaxonomy code 333600000X

License

5301004664 Issued in MI

Legal business name

KD PHARMACY, INC.

Doing business as

Knight Drugs Highland Park 1

Practice address

13820 Woodward Ave
Highland Park, MI 48203-3653

Phone

(313) 868-5800

Fax

(313) 868-1605

NPI assigned

Aug 26, 2005

Last updated

Feb 12, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. John Dejongh

Title

President of Operations

Phone

(248) 540-8066

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Knight Drugs Highland Park 1 Doing business as

Locations

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

{
    "created_epoch": "1125014400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1234396800000",
    "number": "1568455368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2520 INDUSTRIAL ROW DR",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480847035",
            "telephone_number": "248-540-8066",
            "fax_number": "248-540-0112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13820 WOODWARD AVE",
            "city": "HIGHLAND PARK",
            "state": "MI",
            "postal_code": "482033653",
            "telephone_number": "313-868-5800",
            "fax_number": "313-868-1605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KD PHARMACY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-26",
        "last_updated": "2009-02-12",
        "status": "A",
        "authorized_official_last_name": "DEJONGH",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT OF OPERATIONS",
        "authorized_official_telephone_number": "248-540-8066",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "MI",
            "license": "5301004664",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "2342626",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1831248",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1568455368",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Knight Drugs Highland Park 1",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ladonya Jones
• Journey to Healing
• Judah Go Global Foundation, LLC
• Lorina Karreci, LMSW
• Shavneet Kaur
• Laya A Kleinman
• Donna Michele Knight
• Sundra Kollie, M.S.
• Ryan Kunz, MSW
• Katie Lynn Kuschel, LCPC, ATR-BC, CADC

• Pharmacy in Highland Park, MI
• Providers in Highland Park, MI by specialty
• Pharmacy in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2009; 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.