Healthcare Provider Details
I. General information
NPI: 1902910979
Provider Name (Legal Business Name): KL ARNOLD ENTERPRISES INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/18/2006
Last Update Date: 04/28/2025
Certification Date: 04/28/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
11784 AL HIGHWAY 157
VINEMONT AL
35179-9005
US
IV. Provider business mailing address
1001 AVALON AVE
MUSCLE SHOALS AL
35661-2401
US
V. Phone/Fax
- Phone: 256-775-6085
- Fax: 256-736-5984
- Phone: 256-775-6085
- Fax: 256-736-5984
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 333600000X |
| Taxonomy | Pharmacy |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336S0011X |
| Taxonomy | Specialty Pharmacy |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | 112612 |
| License Number State | AL |
VIII. Authorized Official
Name:
KEVIN
ARNOLD
Title or Position: OWNER
Credential: PHARMD
Phone: 256-775-6085