Healthcare Provider Details

I. General information

NPI: 1467559054
Provider Name (Legal Business Name): KZ ENTERPRISES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/17/2006
Last Update Date: 01/13/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

352 RIGHTERS MILL RD
GLADWYNE PA
19035-1543
US

IV. Provider business mailing address

352 RIGHTERS MILL RD
GLADWYNE PA
19035-1543
US

V. Phone/Fax

Practice location:
  • Phone: 610-649-1100
  • Fax: 610-649-4850
Mailing address:
  • Phone: 610-649-1100
  • Fax: 610-649-4850

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPP410872L
License Number StatePA

VIII. Authorized Official

Name: BURTON ZASLOW
Title or Position: PRESIDENT
Credential:
Phone: 610-642-8740