Provider Demographics
NPI:1730480203
Name:KAP3 CO
Entity Type:Organization
Organization Name:KAP3 CO
Other - Org Name:NOBLECARE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KAUR
Authorized Official - Middle Name:
Authorized Official - Last Name:PRABHJEET
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-352-8302
Mailing Address - Street 1:22972 LAHSER RD
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48033-4408
Mailing Address - Country:US
Mailing Address - Phone:248-352-8302
Mailing Address - Fax:248-352-8387
Practice Address - Street 1:22972 LAHSER RD
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48033-4408
Practice Address - Country:US
Practice Address - Phone:248-352-8302
Practice Address - Fax:248-352-8387
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-15
Last Update Date:2011-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI53010093803336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2374750OtherNCPDP PROVIDER IDENTIFICATION NUMBER