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General NPI Number Information
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NPI Number | 1043374937
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Entity Type | Organization
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Legal Business Name | PHARMACY CENTER INC DBA KINGS PHARMACY
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Dates
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Enumeration Date | 12/22/2006
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Last Update Date | 07/01/2009
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Provider Practice Location Address
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Address Line | 251 2ND ST
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City | LAKEWOOD
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State | NJ
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Zip | 08701-3343
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Country | US
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Telephone | 732-364-7302
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Fax | 732-363-7721
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Provider Business Mailing Address
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Address Line | 251 2ND ST
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City | LAKEWOOD
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State | NJ
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Zip | 08701-3343
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Country | US
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Telephone | 732-364-7302
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Fax | 732-363-7721
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. AVRAHAM DOV KING
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Credential | M
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Telephone | 732-364-7302
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | RS5170
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License Number State | NJ
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