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Kenneth Road Pharmacy, Inc.

Debarred entity
TypeCompany[sources]
NameKenneth Road Pharmacy, Inc.[sources]
Incorporation datenot available[sources]
Jurisdictionnot available[sources]
CountryUnited States[sources]
DescriptionLicense number(s): PHY 50214 · Provider number(s): PH0A94460, 1144365776[sources]
Registration numbernot available[sources]
SectorPharmacy/Pharmacist[sources]
Address1400 West Kenneth Rd., Glendale, CA, 91201-1496[sources]
Last changeLast processedFirst seen

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Data sources

US California Medicaid Suspended and ineligible providers22,466

Medical providers suspended from or otherwise deemed ineligible to participate in California's Medicaid program.

United States · DHCS


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