MEDICARE: KENS PHARMACY INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	333600000X	Pharmacy
2	3336C0003X	Community/Retail Pharmacy	002779	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	2032906	OTHER		PK

General Provider Information

NPI Number	:	1710992334
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KENS PHARMACY INC

Provider Business Mailing Address
First Line	:	4626 ALCEE FORTIER BLVD
Second Line	:	STE C
City	:	NEW ORLEANS
State	:	LA
Zip	:	70129-2130
Country	:	US
Telephone Number	:	504-254-8989
Fax Number	:

Provider Business Practice Location Address
First Line	:	4626 ALCEE FORTIER BLVD
Second Line	:	STE C
City	:	NEW ORLEANS
State	:	LA
Zip	:	70129-2130
Country	:	US
Telephone Number	:	504-254-8989
Fax Number	:

Authorized Official
Title or Position	:	PHARMACIST IN CHARGE
Name	:	KINH NGUYEN
Credential	:	RPH
Telephone Number	:	504-254-8989

Provider Enumeration Date	:	07/30/2006
Last Update Date	:	04/17/2013

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Directions to “KENS PHARMACY INC ” Practice Location

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