Active NPI
Kingman Hometown Pharmacy LLC
Doing business as Kingman Hometown Pharmacy
- Pharmacy
- Kingman, AZ
National Provider Identifier
1912918590
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy
- License
- 4304
- Legal business name
- KINGMAN HOMETOWN PHARMACY LLC
- Doing business as
- Kingman Hometown Pharmacy
- Practice address
- 2370 Northern Ave Ste a
Kingman, AZ 86409-2573 - Phone
- (928) 681-4888
- Fax
- (928) 681-4534
- NPI assigned
- Aug 10, 2006
- Last updated
- Jul 21, 2008
- Organization subpart
- Yes
- Parent organization
- KINGMAN HOMETOWN PHARMACY LLC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Jennifer Velez
- Title
- MGR
- Phone
- (928) 681-4888
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | 4304 | AZ | Primary |
| Community/Retail Pharmacy | 3336C0003X |
Addresses
Primary practice location
2370 Northern Ave Ste a
Kingman, AZ 86409-2573
Mailing address
2370 Northern Ave Ste a
Kingman, AZ 86409-2573
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0352992 | Other | OTHER ID NUMBER-COMMERCIAL NUMBER |
Other names 1
- KINGMAN HOMETOWN PHARMACY
National Provider Directory
National Provider Directory- Part of
- Kingman Hometown Pharmacy LLC
Locations
2370 E Northern Ave
Ste A
Kingman, AZ 86409
Phone (928) 681-4888
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155168000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1216598400000",
"number": "1912918590",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2370 NORTHERN AVE STE A",
"city": "KINGMAN",
"state": "AZ",
"postal_code": "864092573"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2370 NORTHERN AVE STE A",
"city": "KINGMAN",
"state": "AZ",
"postal_code": "864092573",
"telephone_number": "928-681-4888",
"fax_number": "928-681-4534"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "KINGMAN HOMETOWN PHARMACY LLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "KINGMAN HOMETOWN PHARMACY LLC",
"enumeration_date": "2006-08-10",
"last_updated": "2008-07-21",
"status": "A",
"authorized_official_last_name": "VELEZ",
"authorized_official_first_name": "JENNIFER",
"authorized_official_title_or_position": "MGR",
"authorized_official_telephone_number": "928-681-4888"
},
"taxonomies": [
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": "AZ",
"license": "4304",
"primary": true
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
"identifier": "0352992",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "KINGMAN HOMETOWN PHARMACY",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Kingman, AZ
- Kingman Healthcare, Inc (Kingman Regional Medical Center)
- Kingman Healthcare, Inc (Kingman Regional Medical Center Hospice)
- Kingman Healthcare, Inc
- Kingman Healthcare, Inc (KRMC Urgent Care)
- Kingman Healthcare, Inc (KRMC Community Pharmacy)
- Kingman Hospital Inc
- Kingman Kidney Clinic Inc.
- Kingman Neurology
- Kingman No 1 LLC (Desert Highlands Care Center)
- Kingman Oncology Institute LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.