Healthcare Provider Details

I. General information

NPI: 1922346584
Provider Name (Legal Business Name): KINGS INFUSION, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/16/2013
Last Update Date: 01/16/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1698 S QUEEN ST
YORK PA
17403-4633
US

IV. Provider business mailing address

1698 S QUEEN ST
YORK PA
17403-4633
US

V. Phone/Fax

Practice location:
  • Phone: 717-846-0500
  • Fax: 717-845-8767
Mailing address:
  • Phone: 717-846-0500
  • Fax: 717-845-8767

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License NumberPP412564L
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License NumberPP412564L
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License NumberPP412564L
License Number StatePA
# 4
Primary TaxonomyN
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License NumberPP412564L
License Number StatePA

VIII. Authorized Official

Name: MR. LYNFORD DOYLE KING
Title or Position: OWNER
Credential:
Phone: 717-846-0500