Individual provider Active NPI

Ken Kozlowski, RPH

  • Pharmacist
  • Wenatchee, WA
National Provider Identifier
1609398163
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PH00017586 Issued in WA
Practice address
1380 N Miller St
Wenatchee, WA 98801-1544
Phone
(509) 663-7805
NPI assigned
Jul 16, 2017
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PH00017586 WA Primary

Addresses

Primary practice location

1380 N Miller St
Wenatchee, WA 98801-1544

Mailing address

1380 N Miller St
Wenatchee, WA 98801-1544
Phone (509) 663-7805

Other practice location 1

250 Basin St SW
Ephrata, WA 98823-1852
Phone (509) 754-3513

Other practice location 2

609 Omache Dr
Omak, WA 98841-9672
Phone (509) 826-2806

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
PH00017586WAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Thrifty Payless Inc Past Accepting new patients
Thrifty Payless Inc PastSince Jul 24, 2022 Accepting new patients
Thrifty Payless Inc Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1500163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1609398163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1380 N MILLER ST",
            "city": "WENATCHEE",
            "state": "WA",
            "postal_code": "988011544",
            "telephone_number": "509-663-7805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1380 N MILLER ST",
            "city": "WENATCHEE",
            "state": "WA",
            "postal_code": "988011544",
            "telephone_number": "509-663-7805"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "250 Basin St SW",
            "address_purpose": "LOCATION",
            "city": "Ephrata",
            "state": "WA",
            "postal_code": "988231852",
            "country_code": "US",
            "telephone_number": "509-754-3513",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "609 Omache Dr",
            "address_purpose": "LOCATION",
            "city": "Omak",
            "state": "WA",
            "postal_code": "988419672",
            "country_code": "US",
            "telephone_number": "509-826-2806",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOZLOWSKI",
        "first_name": "KEN",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-07-16",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "PH00017586",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wenatchee, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.