NPI Code Detail JSON Logo

1629351077 NPI number — KEDVON PHARMACY SOLUTIONS, INC.

NPI Number: 1629351077
Health Care Provider/Practitioner: KEDVON PHARMACY SOLUTIONS, INC.

Information about “1629351077” NPI (KEDVON PHARMACY SOLUTIONS, INC.) exists in 1629351077 in HTML format HTML  |  1629351077 in plain Text format TXT  |  1629351077 in PDF (Portable Document Format) PDF  |  1629351077 in an XML format XML  formats.

NPI Number : 1629351077 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1629351077",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "KEDVON PHARMACY SOLUTIONS, INC.",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "56 SO. MILWAUKEE AVE",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "WHEELING",
    "MailingAddressStateName": "IL",
    "MailingAddressPostalCode": "60090",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "847-459-0001",
    "MailingAddressFaxNumber": "847-947-2972",
    "FirstLinePracticeLocationAddress": "56 SOUTH MILWAUKEE AVE.",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "WHEELING",
    "PracticeLocationAddressStateName": "IL",
    "PracticeLocationAddressPostalCode": "60090",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "847-459-0001",
    "PracticeLocationAddressFaxNumber": "847-947-2972",
    "EnumerationDate": "09/22/2011",
    "LastUpdateDate": "03/01/2024",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "KOROL",
    "AuthorizedOfficialFirstName": "VLADLENA",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "PRESIDENT",
    "AuthorizedOfficialNamePrefix": "MS.",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "PHARM.D.",
    "AuthorizedOfficialTelephoneNumber": "847-459-0001",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "3336C0003X",
          "TaxonomyName": "Community/Retail Pharmacy",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "332B00000X",
          "TaxonomyName": "Durable Medical Equipment & Medical Supplies",
          "LicenseNumber": "054-017721",
          "LicenseNumberStateCode": "IL",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "332BX2000X",
          "TaxonomyName": "Oxygen Equipment & Supplies (DME)",
          "LicenseNumber": "054-017721",
          "LicenseNumberStateCode": "IL",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "333600000X",
          "TaxonomyName": "Pharmacy",
          "LicenseNumber": "054-07721",
          "LicenseNumberStateCode": "IL",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "3336C0004X",
          "TaxonomyName": "Compounding Pharmacy",
          "LicenseNumber": "054-07721",
          "LicenseNumberStateCode": "IL",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "3336C0003X",
          "TaxonomyName": "Community/Retail Pharmacy",
          "LicenseNumber": "054-017721",
          "LicenseNumberStateCode": "IL",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.