Healthcare Provider Details

I. General information

NPI: 1750485710
Provider Name (Legal Business Name): K-C HEALTH SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/12/2006
Last Update Date: 06/26/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4016 MASSILLON RD STE B
UNIONTOWN OH
44685-7818
US

IV. Provider business mailing address

4016 MASSILLON RD STE B
UNIONTOWN OH
44685-7818
US

V. Phone/Fax

Practice location:
  • Phone: 330-899-0406
  • Fax: 330-899-0652
Mailing address:
  • Phone: 330-899-0406
  • Fax: 330-899-0652

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 Number021445650
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: CHARLES CATHER
Title or Position: OWNER
Credential: RPH MBA FASCP
Phone: 330-899-0406