Provider Demographics
NPI:1376894725
Name:KUM CORPORATION
Entity Type:Organization
Organization Name:KUM CORPORATION
Other - Org Name:TOTAL CARE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MAHESHKUMAR
Authorized Official - Middle Name:S
Authorized Official - Last Name:KANERIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-572-9954
Mailing Address - Street 1:19409 SOLEDAD CANYON RD
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARITA
Mailing Address - State:CA
Mailing Address - Zip Code:91351-2632
Mailing Address - Country:US
Mailing Address - Phone:661-250-3800
Mailing Address - Fax:
Practice Address - Street 1:19409 SOLEDAD CANYON RD
Practice Address - Street 2:
Practice Address - City:SANTA CLARITA
Practice Address - State:CA
Practice Address - Zip Code:91351-2632
Practice Address - Country:US
Practice Address - Phone:661-250-3800
Practice Address - Fax:661-250-3806
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-26
Last Update Date:2022-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
CA510373336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA51037OtherCA STATE BOARD OF PHARMACY
CA1376894725Medicaid