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General NPI Number Information
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NPI Number | 1104823582
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Entity Type | Organization
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Legal Business Name | GARY KING PHARMACY INC
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Dates
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Enumeration Date | 06/30/2005
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Last Update Date | 06/10/2025
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Provider Practice Location Address
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Address Line | 1600 COULTER DR STE 307
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City | AMARILLO
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State | TX
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Zip | 79106-1718
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Country | US
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Telephone | 806-358-4576
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Fax | 806-358-4323
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Provider Business Mailing Address
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Address Line | 1600 COULTER DR STE 307
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City | AMARILLO
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State | TX
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Zip | 79106-1718
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Country | US
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Telephone | 806-358-4576
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Fax | 806-358-4323
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Authorized Official
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Title or Position | PRESIDENT
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Name | PAUL PRIEBE
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Credential | RPH
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Telephone | 806-358-4576
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 4755
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License Number State | TX
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