Provider Demographics
NPI:1083344550
Name:KESEM HEALTH PHARMACY LLC
Entity Type:Organization
Organization Name:KESEM HEALTH PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTIAN
Authorized Official - Middle Name:I
Authorized Official - Last Name:ASAMAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:260-804-1669
Mailing Address - Street 1:15827 SUNDEW PRAIRIE DR
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77346-4897
Mailing Address - Country:US
Mailing Address - Phone:260-804-1669
Mailing Address - Fax:
Practice Address - Street 1:15827 SUNDEW PRAIRIE DR
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77346-4897
Practice Address - Country:US
Practice Address - Phone:260-804-1669
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-16
Last Update Date:2022-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy