Healthcare Provider Details

I. General information

NPI: 1730300104
Provider Name (Legal Business Name): III KINGS INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2007
Last Update Date: 07/15/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1550 PRATT ST
PHILADELPHIA PA
19124-1923
US

IV. Provider business mailing address

2801 N 22ND ST
PHILADELPHIA PA
19132-2626
US

V. Phone/Fax

Practice location:
  • Phone: 215-533-9392
  • Fax: 215-533-9391
Mailing address:
  • Phone: 215-226-0355
  • Fax: 215-226-1056

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code156FX1101X
TaxonomyOphthalmic Assistant
License Number
License Number State

VIII. Authorized Official

Name: MR. PAUL KING
Title or Position: CEO
Credential: OPTICIAN
Phone: 215-237-4737