Active NPI
Kingman Healthcare, Inc
Doing business as KRMC Community Pharmacy
- Community/Retail Pharmacy
- Kingman, AZ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- Y007642
- Legal business name
- KINGMAN HEALTHCARE, INC
- Doing business as
- KRMC Community Pharmacy
- Practice address
- 1739 E Beverly Ave Ste 106
Kingman, AZ 86409-3593 - Phone
- (928) 681-8778
- Fax
- (928) 681-8779
- NPI assigned
- Aug 24, 2018
- Last updated
- Jul 2, 2020
- Organization subpart
- Yes
- Parent organization
- KINGMAN HEALTHCARE, INC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Tim Blanchard
- Title
- Cfo
- Phone
- (928) 681-8668
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | Y007642 | AZ | |
| Clinic Pharmacy | 3336C0002X | Y007642 | AZ | |
| Community/Retail Pharmacy | 3336C0003X | Y007642 | AZ | Primary |
Addresses
Primary practice location
1739 E Beverly Ave Ste 106
Kingman, AZ 86409-3593
Mailing address
3269 N Stockton Hill Rd
Kingman, AZ 86409-3619
Phone (928) 757-2101
Other names 2
- KRMC Community Pharmacy
- Kingman Hospital, Inc
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ
Enrollment records 3
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20230801003496 | AZ | Part B Supplier - Pharmacy | 6901791367 | Practice locations: Kingman, AZ |
| O20240523000597 | AZ | Part B Supplier - Mass Immunization (Roster Biller Only) | 6901791367 | Practice locations: Kingman, AZ |
| O20250113001551 | AZ | DME Supplier - Pharmacy | 6901791367 | Practice locations: Kingman, AZ |
Other NPIs with the same Medicare PAC ID 1
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
-
dba Kingman Regional Medical Center
- General Acute Care Hospital
- Kingman, AZ
- NPI 1265423917
6901791367
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| KRMC Community Pharmacy | Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs | Accepts assignment |
National Provider Directory
National Provider Directory- Tax ID family
- Southwest Medical Imagi
- Part of
- Southwest Medical Imagi
Other organizations with this tax ID 4
Organizations that report the same tax identification number in the National Provider Directory.
-
dba Kingman Regional Medical Center Home Health
- Home Health Agency
- Kingman, AZ
- NPI 1174701478
-
dba Kingman Regional Medical Center - Hualapai Mountain Campus
- Rehabilitation Hospital Unit
- Kingman, AZ
- NPI 1184802480
-
dba Kingman Regional Medical Center Hospice
- Community Based Hospice Care Agency
- Kingman, AZ
- NPI 1538347836
Locations
1301 W Beale St
#103
Kingman, AZ 86401
Phone (928) 718-5200
1719 E Beverly Ave
Kingman, AZ 86409
Phone (928) 263-5605
1739 E Beverly Ave
Ste 101
Kingman, AZ 86409
Phone (928) 681-8681
1739 E Beverly Ave
Ste 104
Kingman, AZ 86409
Phone (928) 757-5000
1739 E Beverly Ave
Ste 200
Kingman, AZ 86409
Phone (928) 263-4722
1739 E Beverly Ave
Ste 201
Kingman, AZ 86409
Phone (928) 681-8704
1739 E Beverly Ave
Ste 204
Kingman, AZ 86409
Phone (928) 681-8706
1790 Sycamore Ave
Kingman, AZ 86409
Phone (928) 681-8710
2002 N Stockton Hill Rd
Ste 103
Kingman, AZ 86401
Phone (602) 526-0848
2202 N Stockton Hill Rd
Ste 101
Kingman, AZ 86401
Phone (928) 681-8701
2226 Hualapai Mountain Rd
Ste 100
Kingman, AZ 86401
Phone (928) 681-8530
3116 N Stockton Hill Rd
Kingman, AZ 86401
Phone (928) 681-8742
3801 Santa Rosa Dr
Kingman, AZ 86401
Phone (928) 263-5000
3801 Santa Rosa Dr
Ste 103
Kingman, AZ 86401
Phone (928) 681-8742
3801 Santa Rosa Dr
Ste 105
Kingman, AZ 86401
Phone (928) 681-8751
3801 Santa Rosa Dr
Ste 200
Kingman, AZ 86401
Phone (702) 471-7779
3801 Santa Rosa Dr
Ste D
Kingman, AZ 86401
Phone (928) 681-8738
812 Airway Ave
Kingman, AZ 86409
Phone (928) 681-8710
Practitioners & affiliated clinicians
Practitioners 415
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Acute Care Nurse Practitioner
- Bullhead City, AZ
- NPI 1588479984
-
- Hospice and Palliative Medicine (Family Medicine) Physician
- Kingman, AZ
- NPI 1093153207
-
- Anesthesiology Physician
- Tucson, AZ
- NPI 1811972565
-
- Anesthesiology Physician
- Oro Valley, AZ
- NPI 1902986078
-
- Internal Medicine Physician
- Kingman, AZ
- NPI 1275780991
-
- Cardiovascular Disease Physician
- Mesa, AZ
- NPI 1164484440
-
- Anesthesiology Physician
- Chandler, AZ
- NPI 1508187097
-
- Family Medicine Physician
- Kingman, AZ
- NPI 1255746756
-
- Diagnostic Radiology Physician
- Kingman, AZ
- NPI 1134136260
-
- Podiatrist
- Kingman, AZ
- NPI 1215997069
-
- Orthopaedic Surgery Physician
- Kingman, AZ
- NPI 1629043740
-
- Clinical Cardiac Electrophysiology Physician
- Peoria, AZ
- NPI 1104984491
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1535068800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1593648000000",
"number": "1992286298",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3269 N STOCKTON HILL RD",
"city": "KINGMAN",
"state": "AZ",
"postal_code": "864093619",
"telephone_number": "928-757-2101"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1739 E BEVERLY AVE STE 106",
"city": "KINGMAN",
"state": "AZ",
"postal_code": "864093593",
"telephone_number": "928-681-8778",
"fax_number": "928-681-8779"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "KINGMAN HEALTHCARE, INC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "KINGMAN HEALTHCARE, INC",
"enumeration_date": "2018-08-24",
"last_updated": "2020-07-02",
"certification_date": "2020-07-02",
"status": "A",
"authorized_official_last_name": "BLANCHARD",
"authorized_official_first_name": "TIM",
"authorized_official_title_or_position": "CFO",
"authorized_official_telephone_number": "928-681-8668",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": "AZ",
"license": "Y007642",
"primary": false
},
{
"code": "3336C0002X",
"taxonomy_group": "",
"desc": "Pharmacy, Clinic Pharmacy",
"state": "AZ",
"license": "Y007642",
"primary": false
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "AZ",
"license": "Y007642",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "KRMC Community Pharmacy",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Kingman Hospital, Inc",
"code": "4",
"type": "Former Legal Business Name"
}
]
}
Other providers in Kingman, AZ
- Kingman Healthcare, Inc (Kingman Regional Medical Center - Hualapai Mountain Campus)
- 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 Hometown Pharmacy LLC (Kingman Hometown Pharmacy)
- Kingman Hospital Inc
- Kingman Kidney Clinic Inc.
- Kingman Neurology
- Kingman No 1 LLC (Desert Highlands Care Center)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.