Kongdara LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

31655 Issued in TX

Legal business name

KONGDARA LLC

Practice address

5901 Bell St Ste C32
Amarillo, TX 79109-6231

Phone

(806) 358-2428

Fax

(806) 353-4463

NPI assigned

Aug 3, 2006

Last updated

Jan 31, 2018By 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

Lisa Rogers

Title

Office Administrator

Phone

(806) 358-2428

Specialties & licenses 3

Addresses

Other identifiers 4

Locations

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1517356800000",
    "number": "1679581292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5901 BELL ST STE C32",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791096231",
            "telephone_number": "806-358-2428",
            "fax_number": "806-353-4463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5901 BELL ST STE C32",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791096231",
            "telephone_number": "806-358-2428",
            "fax_number": "806-353-4463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KONGDARA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-03",
        "last_updated": "2018-01-31",
        "status": "A",
        "authorized_official_last_name": "ROGERS",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "OFFICE ADMINISTRATOR",
        "authorized_official_telephone_number": "806-358-2428"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TX",
            "license": "31655",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1429920-01",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NABP",
            "identifier": "4570859",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1429920-02",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "144312",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Whitney Brooke Koch, PHARM D.
• Coby Koehler, DC
• Lloyd D Koen, DDS
• Christopher Thomas Kolze, MD
• Kelsey Kommes, RD, LD
• Sim T Kongdara, PHARMD
• Christina Paloy Kongsy
• Rouzbeh K Kordestani, MD PA
• Kristell M Kotara, LCSW-S
• Amanda Maxey Koumalats, MRC, LPC

• Community/Retail Pharmacy in Amarillo, TX
• Providers in Amarillo, TX by specialty
• Community/Retail Pharmacy in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2018; 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.