Healthcare Provider Details

I. General information

NPI: 1245237502
Provider Name (Legal Business Name): KELSON DRUG INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2005
Last Update Date: 02/03/2025
Certification Date: 02/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3008 JEFFERSON ST SUITE B
MARIANNA FL
32446-2318
US

IV. Provider business mailing address

3008 JEFFERSON ST SUITE B
MARIANNA FL
32446-2318
US

V. Phone/Fax

Practice location:
  • Phone: 850-526-2839
  • Fax: 850-526-5259
Mailing address:
  • Phone: 850-526-2839
  • Fax: 850-526-5259

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: LEE J TEMPLES
Title or Position: PRESIDENT, PHARMACY MANAGER
Credential:
Phone: 850-526-2839