Organization
GKN RX
Active
Other names
GKN Rx
Organization subpart
No
Provider details
NPI number
Authorized official
CHANDRA KADIYALA (CEO)
(509) 392-1958
Entity
Organization
Contact information
Practice address
7072 N CEDAR AVE, FRESNO, CA 93720-3300
(559) 321-8608
(559) 472-3103
Mailing address
7072 N CEDAR AVE, FRESNO, CA 93720-3300
(559) 321-8608
(559) 472-3103
Taxonomy
Speciality
Code
Description
License number
State
332BN1400X
Nursing Facility Supplies (DME)
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
PHY54458
CA
3336L0003X
Long Term Care Pharmacy
Primary
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2164360
PK
—
Enumeration date
09/26/2016
Last updated
04/18/2024
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