Keo Kevin Vongvichith, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

RP00006698 Issued in NM

Practice address

3632 Menaul Blvd NE
Albuquerque, NM 87110-2851

Phone

(505) 217-2551

Fax

(505) 217-2557

NPI assigned

Aug 28, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Keomany Vongvichith Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

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

• Walgreen Co

  • Community/Retail Pharmacy
  • Albuquerque, NM
  • NPI 1255589149
  NPD (past)
• Walgreen Co

  • Pharmacy
  • Longview, TX
  • NPI 1629956545
  NPD (past)

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

{
    "created_epoch": "1251417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1251417600000",
    "number": "1740413426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 MARTHA ST NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871232926",
            "telephone_number": "505-453-6121",
            "fax_number": "505-217-2557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3632 MENAUL BLVD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871102851",
            "telephone_number": "505-217-2551",
            "fax_number": "505-217-2557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VONGVICHITH",
        "first_name": "KEO",
        "middle_name": "KEVIN",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-08-28",
        "last_updated": "2009-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NM",
            "license": "RP00006698",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KEOMANY",
            "last_name": "VONGVICHITH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• April H Volk, MD
• Angela Volpato
• Nicholas A Volpicelli, MD
• Demi Von Amelunxen
• Sravanthi Vonguru, MD
• Morgan Andrea Vonloh, M.D.
• Katharine Vore, M.S., CFY-SLP
• Shana Marie Vorenberg, MD
• Thomas Birdsall Vosburgh, M.D.
• Carolyn Voss

• Pharmacist in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Pharmacist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 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.