Provider Demographics
NPI:1902412414
Name:KOCBECK, KENDI (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:KENDI
Middle Name:
Last Name:KOCBECK
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2486 E BOSTON ST
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85295-2301
Mailing Address - Country:US
Mailing Address - Phone:480-656-1455
Mailing Address - Fax:
Practice Address - Street 1:2486 E BOSTON ST
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85295-2301
Practice Address - Country:US
Practice Address - Phone:480-656-1455
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-20
Last Update Date:2020-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS024904183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist