Individual provider Active NPI

Olga P Kurdelchuk, PHARM.D

  • Pharmacist
  • Phoenix, AZ
National Provider Identifier
1790031888
Registry record updated Jul 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
S018888 Issued in AZ
Practice address
4315 W McDowell Rd
Phoenix, AZ 85035-4201
Phone
(602) 352-0078
Fax
(602) 484-7271
NPI assigned
Jul 26, 2012
Last updated
Jul 26, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X S018888 AZ Primary

Addresses

Primary practice location

4315 W McDowell Rd
Phoenix, AZ 85035-4201

Mailing address

24250 N 23Rd Ave
Apt #1155
Phoenix, AZ 85085-1996

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
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
S018888AZMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co Past Accepting new patients
Walgreen Co Past Accepting new patients

Organizations & group practices 2

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": "1343260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343260800000",
    "number": "1790031888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24250 N 23RD AVE",
            "address_2": "APT #1155",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850851996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4315 W MCDOWELL RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850354201",
            "telephone_number": "602-352-0078",
            "fax_number": "602-484-7271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KURDELCHUK",
        "first_name": "OLGA",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "PHARM.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-26",
        "last_updated": "2012-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AZ",
            "license": "S018888",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 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.