Provider Demographics
NPI:1245270990
Name:KENSINGTON PHARMACY LLC
Entity type:Organization
Organization Name:KENSINGTON PHARMACY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHCY MGR AND OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HUSEYIN
Authorized Official - Middle Name:
Authorized Official - Last Name:TUNC
Authorized Official - Suffix:
Authorized Official - Credentials:BS PHARM, MBA
Authorized Official - Phone:301-933-6165
Mailing Address - Street 1:3737 UNIVERSITY BLVD W
Mailing Address - Street 2:
Mailing Address - City:KENSINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20895-2123
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3737 UNIVERSITY BLVD W
Practice Address - Street 2:
Practice Address - City:KENSINGTON
Practice Address - State:MD
Practice Address - Zip Code:20895-2123
Practice Address - Country:US
Practice Address - Phone:301-933-6165
Practice Address - Fax:301-933-6185
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-08
Last Update Date:2008-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
MDP043713336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD5754780002Medicare NSC