Healthcare Provider Details

I. General information

NPI: 1295649663
Provider Name (Legal Business Name): KEJSI BENDO PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KEJSI BENDO PAVLIQOTI PHARMD

II. Dates (important events)

Enumeration Date: 10/01/2026
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1576 HIGHWAY 17 N
NORTH MYRTLE BEACH SC
29582-2552
US

IV. Provider business mailing address

23505 URBAN ST
MACOMB MI
48042-5513
US

V. Phone/Fax

Practice location:
  • Phone: 843-272-0050
  • Fax:
Mailing address:
  • Phone: 586-419-8789
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH.67764PH
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: