Healthcare Provider Details

I. General information

NPI: 1861918088
Provider Name (Legal Business Name): KILPATRICK PHARMACY INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2017
Last Update Date: 08/18/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

415 COUNTY ROAD 179
CROSSVILLE AL
35962
US

IV. Provider business mailing address

241 BILLY DYAR BLVD
BOAZ AL
35957-7102
US

V. Phone/Fax

Practice location:
  • Phone: 256-593-1500
  • Fax: 256-593-1501
Mailing address:
  • Phone: 256-840-1100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: BRANDON JONES
Title or Position: OWNER/PHARMACIST
Credential:
Phone: 256-840-1100