Kenco Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

5301007786 Issued in MI

Legal business name

KENCO INC

Practice address

1535 W Maumee St
Adrian, MI 49221-1805

Phone

(517) 265-9162

Fax

(517) 266-1455

NPI assigned

Sep 12, 2006

Organization subpart

No

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

Authorized official

Name

Grant Brown, PHARM.D.

Title

Dir of Pharmacy Operations

Phone

(517) 789-8980

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• COUNTRY MARKET PHARMACY #11 Doing business as

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

{
    "created_epoch": "1158019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531958400000",
    "number": "1700980760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1821 SPRING ARBOR RD",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492032703",
            "telephone_number": "517-787-6081",
            "fax_number": "517-787-0160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1535 W MAUMEE ST",
            "city": "ADRIAN",
            "state": "MI",
            "postal_code": "492211805",
            "telephone_number": "517-265-9162",
            "fax_number": "517-266-1455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENCO INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-12",
        "last_updated": "2018-07-19",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "GRANT",
        "authorized_official_title_or_position": "DIR OF PHARMACY OPERATIONS",
        "authorized_official_telephone_number": "517-789-8980",
        "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": "MI",
            "license": "5301007786",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2044382",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2359506",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "COUNTRY MARKET PHARMACY #11",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Rod A Kaufman
• Leslie N Keane, LMT
• Don E Keener, MD
• Sonya A Kelley, LPN
• Elizabeth Kelly
• Erica Kenner, CCC-SLP
• Willis Kim Kern-Ruesink
• Kimberly Yoder, Llmsw PLLC
• Michelle Mae Kimbrell, LMT
• Victoria Maria Kimbrell, LMT

• Community/Retail Pharmacy in Adrian, MI
• Providers in Adrian, MI by specialty
• Community/Retail Pharmacy in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 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.