Provider Demographics
NPI:1831330687
Name:KENDALL CHEMIST INC
Entity type:Organization
Organization Name:KENDALL CHEMIST INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICEPRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANGEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:VP
Authorized Official - Phone:305-378-2134
Mailing Address - Street 1:13170 SW 128TH ST
Mailing Address - Street 2:SUITE 104
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-5845
Mailing Address - Country:US
Mailing Address - Phone:305-378-2134
Mailing Address - Fax:305-259-7528
Practice Address - Street 1:13170 SW 128TH ST
Practice Address - Street 2:SUITE 104
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-5845
Practice Address - Country:US
Practice Address - Phone:305-378-2134
Practice Address - Fax:305-259-7528
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-07
Last Update Date:2009-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH23707333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy