Healthcare Provider Details

I. General information

NPI: 1932273307
Provider Name (Legal Business Name): KEMPS PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2006
Last Update Date: 12/18/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

246 S MAIN ST STE A
REIDSVILLE GA
30453-4663
US

IV. Provider business mailing address

246 S MAIN ST STE A
REIDSVILLE GA
30453-4663
US

V. Phone/Fax

Practice location:
  • Phone: 912-557-4000
  • Fax: 912-557-4080
Mailing address:
  • Phone: 912-557-4000
  • Fax: 912-557-4080

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPHRE008636
License Number StateGA
# 4
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: HAL KEMP
Title or Position: MGR
Credential: RPH
Phone: 912-557-4000