Individual ProviderKenneth WardPharmacistPharmacy Service ProvidersPractice Address5415 S Broadway Ave, Tyler, TX 75703-1397(903) 939-9298(903) 283-1877PECOS EnrollmentBased on the most recent information from CMS, provider Kenneth Ward does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1851674592Provider TypeIndividualFull NameWard, KennethGenderMaleSole ProprietorYesEnumeration Date9/20/2011Last Updated9/20/2011Contact InformationPractice LocationPractice Address5415 S Broadway Ave, Tyler, TX 75703-1397Phone(903) 939-9298FaxUnlisted FaxMailing LocationMailing Address323 Chimney Rock Dr Apt 1713, Tyler, TX 75703-4130Phone(903) 283-1877FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode183500000XPrimaryDescriptionPharmacistPharmacy Service ProvidersLicense50540Texas