Active NPI
Kendall Phan
- Pharmacy Technician
- Randolph, MA
National Provider Identifier
1790695211
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy Technician
- Practice address
- 1178 N Main St
Randolph, MA 02368-2127 - Phone
- (781) 785-1912
- NPI assigned
- Sep 8, 2026
- Sex
- Unspecified or another gender identity
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy Technician | 183700000X | Primary |
Addresses
Primary practice location
1178 N Main St
Randolph, MA 02368-2127
Mailing address
1178 N Main St
Randolph, MA 02368-2127
Phone (781) 785-1912
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1788825600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1788825600000",
"number": "1790695211",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1178 N MAIN ST",
"city": "RANDOLPH",
"state": "MA",
"postal_code": "023682127",
"telephone_number": "781-785-1912"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1178 N MAIN ST",
"city": "RANDOLPH",
"state": "MA",
"postal_code": "023682127",
"telephone_number": "781-785-1912"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHAN",
"first_name": "KENDALL",
"sole_proprietor": "NO",
"sex": "X",
"enumeration_date": "2026-09-08",
"last_updated": "2026-09-08",
"certification_date": "2026-09-08",
"status": "A"
},
"taxonomies": [
{
"code": "183700000X",
"taxonomy_group": "",
"desc": "Pharmacy Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Randolph, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.