Kenneth Alan Wudel, PHARM D

Primary specialty

PharmacistTaxonomy code 183500000X

License

30928 Issued in CA

Practice address

407 Main St. Delta Pharmacy
Rio Vista, CA 94571

Phone

(707) 374-5135

Fax

(707) 374-5408

NPI assigned

Oct 25, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

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.

• Pace Zone Pharmacy

  • Pharmacy
  • Rio Vista, CA
  • NPI 1649312174
  NPD (past)
• Pace Zone Pharmacy LLC

  • Pharmacy
  • Rio Vista, CA
  • NPI 1124842513
  NPD (past)

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

{
    "created_epoch": "1540425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540425600000",
    "number": "1871060087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 APPLEWOOD DR.",
            "city": "LODI",
            "state": "CA",
            "postal_code": "95242",
            "telephone_number": "209-334-5499",
            "fax_number": "707-374-5408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 MAIN ST. DELTA PHARMACY",
            "city": "RIO VISTA",
            "state": "CA",
            "postal_code": "94571",
            "telephone_number": "707-374-5135",
            "fax_number": "707-374-5408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WUDEL",
        "first_name": "KENNETH",
        "middle_name": "ALAN",
        "credential": "PHARM D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-10-25",
        "last_updated": "2018-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "30928",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Claudio Verano, PA-C
• Leann Walker
• Nancy Karen West-Thompson, ASW
• Roderick Williams, LMSW
• Sharonda Williams, PPC
• Your Great Smile,Inc. a Dental Hygiene Practice of Vange Leonis, Rdhap

• Pharmacist in Rio Vista, CA
• Providers in Rio Vista, CA by specialty
• Pharmacist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2018; 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.