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General NPI Number Information
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NPI Number | 1720322944
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Entity Type | Individual
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Provider Name | KEVIN KANE RPH
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Gender | Male
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Dates
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Enumeration Date | 11/15/2012
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Last Update Date | 11/15/2012
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Provider Practice Location Address
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Address Line | 2887 S MARKET ST
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City | GILBERT
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State | AZ
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Zip | 85295-1303
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Country | US
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Telephone | 480-366-3959
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Fax | 480-366-3956
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Provider Business Mailing Address
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Address Line | 2887 S MARKET ST
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City | GILBERT
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State | AZ
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Zip | 85295-1303
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Country | US
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Telephone | 480-366-3959
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Fax | 480-366-3956
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 10892
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License Number State | AZ
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