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General NPI Number Information
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NPI Number | 1104139294
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Entity Type | Organization
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Legal Business Name | KINGS DRUGS INC
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Dates
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Enumeration Date | 07/19/2010
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Last Update Date | 07/19/2010
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Provider Practice Location Address
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Address Line | 35930 HWY 27
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City | HAINES CITY
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State | FL
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Zip | 33844-3737
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Country | US
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Telephone | 863-422-1888
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Fax | 863-422-1811
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Provider Business Mailing Address
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Address Line | 35930 HWY 27
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City | HAINES CITY
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State | FL
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Zip | 33844-3737
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Country | US
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Telephone | 863-422-1888
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Fax | 863-422-1811
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. ABIOLA ODUOLA FADARE
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Credential |
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Telephone | 813-390-2482
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PH24732
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License Number State | FL
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