Provider Demographics
NPI:1356923411
Name:KENDALL PHARMACY LLC
Entity type:Organization
Organization Name:KENDALL PHARMACY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHARMACIST/PIC
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:KENDALL
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM-D
Authorized Official - Phone:989-720-4295
Mailing Address - Street 1:211 N SHIAWASSEE ST STE E
Mailing Address - Street 2:
Mailing Address - City:CORUNNA
Mailing Address - State:MI
Mailing Address - Zip Code:48817-1444
Mailing Address - Country:US
Mailing Address - Phone:989-720-4295
Mailing Address - Fax:
Practice Address - Street 1:211 N SHIAWASSEE ST STE E
Practice Address - Street 2:
Practice Address - City:CORUNNA
Practice Address - State:MI
Practice Address - Zip Code:48817-1444
Practice Address - Country:US
Practice Address - Phone:989-720-4295
Practice Address - Fax:989-720-4296
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-27
Last Update Date:2021-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy