Provider Demographics
NPI:1801446414
Name:KERMED PHARMACY LLC
Entity type:Organization
Organization Name:KERMED PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RODRIGO
Authorized Official - Middle Name:
Authorized Official - Last Name:AHUMADA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-495-5134
Mailing Address - Street 1:6729 BANDERA RD
Mailing Address - Street 2:
Mailing Address - City:LEON VALLEY
Mailing Address - State:TX
Mailing Address - Zip Code:78238-1438
Mailing Address - Country:US
Mailing Address - Phone:210-957-0098
Mailing Address - Fax:
Practice Address - Street 1:6729 BANDERA RD
Practice Address - Street 2:
Practice Address - City:LEON VALLEY
Practice Address - State:TX
Practice Address - Zip Code:78238-1438
Practice Address - Country:US
Practice Address - Phone:210-957-0098
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KERMED PHARMACY LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-09-16
Last Update Date:2019-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy