Kathleen Lynn Vandenbos, PHARMACY TECHNICIAN

Primary specialty

Pharmacy TechnicianTaxonomy code 183700000X

License

5303006731 Issued in MI

Practice address

102 N Centerville Rd
Sturgis, MI 49091-1308

Phone

(269) 651-7818

Fax

(269) 659-2619

NPI assigned

Jun 2, 2021

Last updated

Jun 2, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

State licenses

Practice roles

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.

• Rite Aid of Michigan Inc

  dba Rite Aid Pharmacy 04234

  • Community/Retail Pharmacy
  • Sturgis, MI
  • NPI 1023127594
  NPD (past)
• Rite Aid of Michigan Inc

  dba Rite Aid Pharmacy 04068

  • Community/Retail Pharmacy
  • Washington, MI
  • NPI 1619117405
  NPD (past)

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

{
    "created_epoch": "1622592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622592000000",
    "number": "1881260651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 N CENTERVILLE RD",
            "city": "STURGIS",
            "state": "MI",
            "postal_code": "490911308",
            "telephone_number": "269-651-7818",
            "fax_number": "269-651-7818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 N CENTERVILLE RD",
            "city": "STURGIS",
            "state": "MI",
            "postal_code": "490911308",
            "telephone_number": "269-651-7818",
            "fax_number": "269-659-2619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDENBOS",
        "first_name": "KATHLEEN",
        "middle_name": "LYNN",
        "credential": "PHARMACY TECHNICIAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-02",
        "last_updated": "2021-06-02",
        "certification_date": "2021-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183700000X",
            "taxonomy_group": "",
            "desc": "Pharmacy Technician",
            "state": "MI",
            "license": "5303006731",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Trail Finders PLLC
• Benjamin Travers, MD
• Trevor Neal DPM
• Traci J Van Gorden, CFNP
• Ashley Vanaman
• Ashish Verma, M.D.
• Vicente D Cabansag Jr MD PC
• Alyssa Vowels
• Wal-Mart Stores East LP (Walmart Pharmacy 10-1771)
• Wal-Mart Stores East, LP (Vision Center 30-1771)

• Pharmacy Technician in Sturgis, MI
• Providers in Sturgis, MI by specialty
• Pharmacy Technician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2021; 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.