Healthcare Provider Details

I. General information

NPI: 1164376521
Provider Name (Legal Business Name): KINGS WELLNESS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/23/2026
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7043 YANKEE RD
LIBERTY TOWNSHIP OH
45044-9132
US

IV. Provider business mailing address

7043 YANKEE RD
LIBERTY TOWNSHIP OH
45044-9132
US

V. Phone/Fax

Practice location:
  • Phone: 513-222-7721
  • Fax: 513-964-9053
Mailing address:
  • Phone: 513-804-3266
  • Fax: 800-565-3179

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: TATUM KING
Title or Position: OWNER
Credential: PHARMD
Phone: 513-240-4167