| NPI | 1043626153 |
|---|---|
| NPI Type | NPI-2 Organization |
| Status | Active |
| Enumeration Date | 2014-07-09 |
| Last Updated | 2023-05-01 |
| Authorized Official | Chen Oeur Pharmacist/Pharmacy Owner Phone: 9045515870 |
| Mailing Address | 11643 Beach Blvd, Unit A Jacksonville, FL 32246 United States Phone: (904) 551-5870 | Fax: (904) 619-6227 📍 View Map |
| Primary Practice Address | 11643 Beach Blvd, Unit A Jacksonville, FL 32246 United States Phone: (904) 551-5870 | Fax: (904) 619-6227 📍 View Map |
| Issuer | State | Number | Other Issuer |
|---|---|---|---|
| MEDICAID | FL | 013879700 | — |
| Other (non-Medicare) | — | 2147617 | PK |
| Primary | Taxonomy Code & Description | State | License Number |
|---|---|---|---|
| Yes | 3336C0003X – Pharmacy, Community/Retail Pharmacy | FL | PH28291 |
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About NPI 1043626153
Pich Ktm Corp is an organization registered in the CMS NPPES NPI Registry with NPI number 1043626153. The primary specialty listed is Pharmacy, Community/Retail Pharmacy. The organization is located in Jacksonville, FL. This NPI is classified as a Type 2 (Organizational) NPI and is currently active. The NPI was first enumerated (assigned) on 2014-07-09. All data is sourced directly from the official CMS NPPES public API and is updated daily.
Frequently Asked Questions
What is NPI 1043626153?
NPI 1043626153 belongs to Pich Ktm Corp, a Pharmacy, Community/Retail Pharmacy in Jacksonville, FL. It is a Type 2 Organizational NPI registered in the CMS NPPES NPI Registry.
Is NPI 1043626153 active?
The current status of NPI 1043626153 in the NPPES registry is Active. The record was last updated on 2023-05-01.
What specialty is NPI 1043626153?
NPI 1043626153 is classified under the taxonomy Pharmacy, Community/Retail Pharmacy. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.
How do I verify NPI 1043626153?
You can verify NPI 1043626153 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.
What address is on file for NPI 1043626153?
The primary practice address on file for NPI 1043626153 is 11643 Beach Blvd, Jacksonville, FL 32246. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.
When was NPI 1043626153 issued?
NPI 1043626153 was first issued (enumerated) on 2014-07-09. The NPPES record was last updated on 2023-05-01.
Practice Location Map
Pich Ktm Corp is located at 11643 Beach Blvd, Jacksonville, FL. Use the map below to find directions or verify the practice location.
Related Healthcare Providers
The following providers share the same practice location, specialty, or state as Pich Ktm Corp. All records sourced from the CMS NPPES registry.
License Information
The following state license numbers are on file in the NPPES registry for NPI 1043626153. For license status verification, contact the relevant state licensing board directly.
| Specialty / Taxonomy | License Number | State |
|---|---|---|
| Pharmacy, Community/Retail Pharmacy | PH28291 | FL |