Organization Name: | KODO PHARMACY INC |
NPI Number: | 1215223755 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | CHAD KODIAK (PRESIDENT) |
Mailing Address: | 1522 E Washington St Joliet |
State: | IL US |
Postal Code: | 604331365 |
Phone Number: | 8157274721 |
Fax Number: | 8157277839 |
NPI Enumeration Date: | 06/23/2011 |
NPI Last Update Date: | 09/27/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332B00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | |
Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |