KC Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

0201004087 Issued in VA

Legal business name

KC PHARMACY LLC

Doing business as

KC Pharmacy

Practice address

8988 Lorton Station Blvd
Lorton, VA 22079-4756

Phone

(703) 339-9599

Fax

(703) 339-7111

NPI assigned

Aug 18, 2006

Organization subpart

No

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

Authorized official

Name

Farhad Moalem, MSME

Title

President Owner

Phone

(703) 339-9599

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• KC PHARMACY Doing business as

Locations

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1328659200000",
    "number": "1760596753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8988 LORTON STATION BLVD",
            "city": "LORTON",
            "state": "VA",
            "postal_code": "220794756",
            "telephone_number": "703-339-9599",
            "fax_number": "703-339-7111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8988 LORTON STATION BLVD",
            "city": "LORTON",
            "state": "VA",
            "postal_code": "220794756",
            "telephone_number": "703-339-9599",
            "fax_number": "703-339-7111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KC PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-18",
        "last_updated": "2012-02-08",
        "status": "A",
        "authorized_official_last_name": "MOALEM",
        "authorized_official_first_name": "FARHAD",
        "authorized_official_title_or_position": "PRESIDENT OWNER",
        "authorized_official_telephone_number": "703-339-9599",
        "authorized_official_credential": "MSME"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "VA",
            "license": "0201004087",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "4839328",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010275776",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "KC PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Metsihet L Kebede
• Angelynn G Keighin, BEHAVIOR TECHNICIAN
• Key Affinity Healthcare LLC
• Samer K Khattab, DDS
• Daneshia Michelle Kidd, OT

• Community/Retail Pharmacy in Lorton, VA
• Providers in Lorton, VA by specialty
• Community/Retail Pharmacy in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2012; 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.