NPIMap

Organization Active NPI

KC Pharma LLC

  • Long Term Care Pharmacy
  • Livonia, MI
National Provider Identifier
1578086815
Registry record updated Aug 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
License
5301010939 Issued in MI
Legal business name
KC PHARMA LLC
Practice address
37672 Professional Center Dr Ste 130B
Livonia, MI 48154-1140
Phone
(734) 432-2015
Fax
(734) 432-2016
NPI assigned
Jul 19, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2022

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

Authorized official

Name
Mr. Khalil Chahine, PHARMD
Title
Owner
Phone
(734) 432-2015

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X 5301010939 MI
Long Term Care Pharmacy 3336L0003X 5301010939 MI Primary

Addresses

Primary practice location

37672 Professional Center Dr Ste 130B
Livonia, MI 48154-1140

Mailing address

37672 Professional Center Dr Ste 130B
Livonia, MI 48154-1140
Phone (734) 432-2015

Other names 1

  • LTC Ray's Drugs Doing business as

National Provider Directory

National Provider Directory
Tax ID family
KC Pharma LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

37672 Professional Center Dr
Ste 130B
Livonia, MI 48154
Phone (734) 432-2015

NPI Registry JSON

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

{
    "created_epoch": "1500422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661126400000",
    "number": "1578086815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37672 PROFESSIONAL CENTER DR STE 130B",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481541140",
            "telephone_number": "734-432-2015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37672 PROFESSIONAL CENTER DR STE 130B",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481541140",
            "telephone_number": "734-432-2015",
            "fax_number": "734-432-2016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KC PHARMA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-19",
        "last_updated": "2022-08-22",
        "certification_date": "2022-08-22",
        "status": "A",
        "authorized_official_last_name": "CHAHINE",
        "authorized_official_first_name": "KHALIL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "734-432-2015",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "MI",
            "license": "5301010939",
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "MI",
            "license": "5301010939",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LTC Ray's Drugs",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Livonia, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2022; 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.