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NPI Code Detail

MEDICARE: GKN RX

MEDICARE: GKN RX
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
13336C0003XCommunity/Retail PharmacyPHY54458CA
23336S0011XSpecialty Pharmacy
3332BN1400XNursing Facility Supplies (DME)
4333600000XPharmacy
53336L0003XLong Term Care Pharmacy

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12164360OTHERPK

General Provider Information

NPI Number : 1588113088
Entity Type Code : Organization
Provider Name (Legal Business Name) : GKN RX
Provider Business Mailing Address
First Line : 7072 N CEDAR AVE
Second Line :
City : FRESNO
State : CA
Zip : 93720-3300
Country : US
Telephone Number : 559-321-8608
Fax Number : 559-472-3103
Provider Business Practice Location Address
First Line : 7072 N CEDAR AVE
Second Line :
City : FRESNO
State : CA
Zip : 93720-3300
Country : US
Telephone Number : 559-321-8608
Fax Number : 559-472-3103
Authorized Official
Title or Position : CEO
Name : CHANDRA KADIYALA
Credential :
Telephone Number : 509-392-1958
Provider Enumeration Date : 09/26/2016
Last Update Date : 04/18/2024

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Directions to “GKN RX ” Practice Location

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