Ken Von Eiland

Primary specialty

PharmacistTaxonomy code 183500000X

License

16472 Issued in GA

Practice address

2103 Veterans Blvd
Unit 2
Dublin, GA 31021-7502

Phone

(478) 274-5362

Fax

(303) 398-5278

NPI assigned

Jul 19, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Mr. Kenton Von Eiland Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323648000000",
    "number": "1861411571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "327 REGENCY CIR",
            "city": "DUBLIN",
            "state": "GA",
            "postal_code": "310214315",
            "telephone_number": "478-274-5362",
            "fax_number": "303-398-5278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2103 VETERANS BLVD",
            "address_2": "UNIT 2",
            "city": "DUBLIN",
            "state": "GA",
            "postal_code": "310217502",
            "telephone_number": "478-274-5362",
            "fax_number": "303-398-5278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EILAND",
        "first_name": "KEN",
        "middle_name": "VON",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2011-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "GA",
            "license": "16472",
            "primary": true
        },
        {
            "code": "1835P1200X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacotherapy",
            "state": "GA",
            "license": "16472",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KENTON",
            "last_name": "EILAND",
            "middle_name": "VON",
            "prefix": "MR.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Pharmacist in Dublin, GA
• Providers in Dublin, GA by specialty
• Pharmacist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2011; 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.