Organization
KODO CARE, INC.
Active
Other names
Kodo Care, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
CHAD KODIAK (PHARM D/PRESIDENT)
(815) 727-4722
Entity
Organization
Contact information
Practice address
2401 W JEFFERSON ST STE 100, JOLIET, IL 60435-6428
(815) 727-4722
(815) 727-4731
Mailing address
2401 W JEFFERSON ST STE 100, JOLIET, IL 60435-7830
(815) 727-4722
(815) 727-4731
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
—
—
3336C0004X
Compounding Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
054-018457
IL
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2146567
PK
—
Enumeration date
07/31/2014
Last updated
09/01/2023
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