Provider Demographics
NPI:1982007480
Name:SILVE, KENDAL BLAINE (PHARM D)
Entity Type:Individual
Prefix:MR
First Name:KENDAL
Middle Name:BLAINE
Last Name:SILVE
Suffix:
Gender:M
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:PO BOX 4445
Mailing Address - Street 2:
Mailing Address - City:BILOXI
Mailing Address - State:MS
Mailing Address - Zip Code:39535-4445
Mailing Address - Country:US
Mailing Address - Phone:228-207-0960
Mailing Address - Fax:228-207-2787
Practice Address - Street 1:1701 HIGHWAY 43 N
Practice Address - Street 2:
Practice Address - City:PICAYUNE
Practice Address - State:MS
Practice Address - Zip Code:39466-2844
Practice Address - Country:US
Practice Address - Phone:769-926-2740
Practice Address - Fax:769-926-2741
Is Sole Proprietor?:No
Enumeration Date:2014-09-29
Last Update Date:2018-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSE-010754183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist