Provider Demographics
NPI:1700345824
Name:KAY, KERMIT EUGENE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KERMIT
Middle Name:EUGENE
Last Name:KAY
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5401 N PORTLAND AVE STE 250
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-2082
Mailing Address - Country:US
Mailing Address - Phone:405-749-0600
Mailing Address - Fax:
Practice Address - Street 1:5401 N PORTLAND AVE STE 250
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-2082
Practice Address - Country:US
Practice Address - Phone:405-749-0600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-18
Last Update Date:2019-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK138571835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist