1801060298 NPI number — K & K RX SERVICES, LP

Table of content: MARY CATHERINE ELLIS PT (NPI 1649409970)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801060298 NPI number — K & K RX SERVICES, LP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
K & K RX SERVICES, LP
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
BIOMATRIX SPECIALTY PHARMACY PA
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1801060298
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/06/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3070 MCCANN FARM DR
Provider Second Line Business Mailing Address:
STE 101
Provider Business Mailing Address City Name:
GARNET VALLEY
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19060-2131
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
610-545-6040
Provider Business Mailing Address Fax Number:
610-545-6030

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3070 MCCANN FARM DR
Provider Second Line Business Practice Location Address:
STE 101
Provider Business Practice Location Address City Name:
GARNET VALLEY
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19060
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-545-6040
Provider Business Practice Location Address Fax Number:
610-545-6030
Provider Enumeration Date:
04/16/2008

Additional Information

Authorized Official

Authorized Official Last Name:
KRAMM
Authorized Official First Name:
KATHEE
Authorized Official Middle Name:
M
Authorized Official Title or Position:
CEO, PRESIDENT, LLC MANAGER OF G.P.
Authorized Official Telephone Number:
954-385-7322

Provider Taxonomy Codes

  • Taxonomy code: 3336H0001X , with the licence number:  PP481819 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336S0011X , with the licence number: PP481819 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1801060298 , issued by the state of ( UT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1801060298 , issued by the state of ( MT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 30004882850001 , issued by the state of ( KS ) . This identifiers is of the category "MEDICAID".
  • Identifier: 170390003 , issued by the state of ( ID ) . This identifiers is of the category "MEDICAID".
  • Identifier: 297732407 , issued by the state of ( AR ) . This identifiers is of the category "MEDICAID".
  • Identifier: 3142680 , issued by the state of ( NH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 582104 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7100385430 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: Q047416 , issued by the state of ( TN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1801060298 , issued by the state of ( MN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1801060298 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1801060298 , issued by the state of ( ME ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2209949 , issued by the state of ( LA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 47018300 , issued by the state of ( DC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 95809546 , issued by the state of ( NM ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1008270470003 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1801060298 , issued by the state of ( WI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 19252 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 220703600 , issued by the state of ( WY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 250541042 , issued by the state of ( DE ) . This identifiers is of the category "MEDICAID".




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