Healthcare Provider Details

I. General information

NPI: 1154712685
Provider Name (Legal Business Name): K L ARNOLD ENTERPRISES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2015
Last Update Date: 02/18/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1726 CHEROKEE AVE SW STE A
CULLMAN AL
35055-5383
US

IV. Provider business mailing address

1001 AVALON AVE
MUSCLE SHOALS AL
35661-2401
US

V. Phone/Fax

Practice location:
  • Phone: 256-775-7455
  • Fax: 256-381-8065
Mailing address:
  • Phone: 256-775-7455
  • Fax: 256-381-8065

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number114451
License Number StateAL
# 3
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: KL ARNOLD
Title or Position: OWNER
Credential:
Phone: 256-775-7455