Healthcare Provider Details

I. General information

NPI: 1922101062
Provider Name (Legal Business Name): K C DRUGS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/06/2006
Last Update Date: 06/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HWY 83 S HEMPHILL
HEMPHILL TX
75948
US

IV. Provider business mailing address

PO BOX 790
HEMPHILL TX
75948-0790
US

V. Phone/Fax

Practice location:
  • Phone: 409-787-2345
  • Fax: 409-787-2345
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number10314
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: WC KITTMAN
Title or Position: OWNER
Credential:
Phone: 408-787-2345