KAMAL KOTAICH (NPI# 1770059537) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770059537 |
| Entity Type | Individual |
| Full Name | KAMAL KOTAICH |
| Practice Address |
140 S Holly St Ste 1131 Medford OR 97501-3113 |
| Practice Telephone | 8009676816 |
| Mailing Telephone | 8009676816 |
| Enumeration Date | 2018-10-19 |
| Last Update Date | 2018-10-19 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | RPH-0009624 | OR | Pharmacy Service Providers |
| Street Address |
140 S HOLLY ST STE 1131 |
| City | MEDFORD |
| State | OR |
| Zip Code | 97501-3113 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366069494 | Brian Snapp | Counselor | 1191 Hazel St, Medford, OR 97501 | 2020-07-06 |
| 1477174761 | Corey Renfree | Counselor | 1191 Hazel Street, Medford, OR 97501 | 2020-04-28 |
| 1669012928 | One of A Kind Therapy LLC | Social Worker | 916 West 10th St #205, Medford, OR 97501 | 2020-01-14 |
| 1265993620 | Star Dialysis LLC | Clinic/Center | 50 Rossanley Dr, Medford, OR 97501 | 2019-03-28 |
| 1962972463 | Karen Elise Roertgen | Counselor | 328 So. Central Ave., Suite 204, Medford, OR 97501 | 2018-11-28 |
| 1316458813 | Rick's Medical Supply, Inc | Durable Medical Equipment & Medical Supplies | 562 Parsons Drive, Suite 114, Medford, OR 97501 | 2017-10-24 |
| 1750807111 | La Clinica Del Valle Family Health Care Center Inc. | Clinic/Center | 821 N Riverside Ave, Medford, OR 97501 | 2017-08-17 |
| 1992229009 | Cassandra Schultz | Massage Therapist | 824 East Jackson, Suite A, Medford, OR 97501 | 2017-07-31 |
| 1972962355 | Robin Clevenger | Peer Specialist | 301 S Ivy St, Medford, OR 97501 | 2016-02-15 |
| 1154706984 | Debbie Diane Orr | Behavioral Analyst | 1024 West 9th Street, Medford, OR 97501 | 2015-07-22 |
| Find all providers in zip 97501 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386245934 | Stephen Choi | Pharmacist | 12 Blakely Rd, Medford, MA 02155-2409 | 2020-11-02 |
| 1366084592 | Michael Kasik | Pharmacist | 701 Black Oak Dr, Medford, OR 97504-8550 | 2019-10-09 |
| 1316594898 | Christ Ange G Katche | Pharmacist | 21 College Ave Apt 1, Medford, MA 02155-4571 | 2019-08-20 |
| 1295203677 | Hajar Taman | Pharmacist | 2975 Horseblock Road, Medford, NY 11763 | 2018-11-05 |
| 1851778211 | Kyle Mason | Pharmacist | 34 Tallowood Dr, Medford, NJ 08055-9147 | 2015-05-05 |
| 1174931331 | Justina Sokolovas | Pharmacist | 1350 Center Drive, Pharmacy Department, Medford, OR 97501 | 2014-07-31 |
| 1295152759 | Marvin Wainwright | Pharmacist | 5 Wilkins Station Rd, Suite 100, Medford, NJ 08055-9606 | 2014-03-23 |
| 1780008466 | Catherine Rimov | Pharmacist | 4449 Vista Pointe Dr, Medford, OR 97504-8084 | 2014-02-14 |
| 1992141584 | Jerry C Hood | Pharmacist | 2425 Nieto Way, Medford, OR 97504-8577 | 2013-05-22 |
| 1164780318 | Brett A. Summers | Pharmacist | 3528 Lone Pine Rd, Medford, OR 97504 | 2012-04-25 |
| Find all providers in MEDFORD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.