Provider Demographics
NPI:1982214763
Name:KEMPO CORPORATION
Entity Type:Organization
Organization Name:KEMPO CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:ABDUL
Authorized Official - Middle Name:KARIM
Authorized Official - Last Name:SALAHEDDINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:980-273-9668
Mailing Address - Street 1:4506 STATESVILLE RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28269-4250
Mailing Address - Country:US
Mailing Address - Phone:704-563-7953
Mailing Address - Fax:
Practice Address - Street 1:6096 HIGHWAY 151
Practice Address - Street 2:
Practice Address - City:JEFFERSON
Practice Address - State:SC
Practice Address - Zip Code:29718-5813
Practice Address - Country:US
Practice Address - Phone:843-658-3540
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-05
Last Update Date:2020-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory