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General NPI Number Information
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NPI Number | 1174869622
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Entity Type | Organization
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Legal Business Name | KENNEDY LLC
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Dates
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Enumeration Date | 01/02/2013
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Last Update Date | 03/23/2017
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Provider Practice Location Address
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Address Line | 859 E HOBSON ST
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City | TUSCUMBIA
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State | AL
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Zip | 35674-1428
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Country | US
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Telephone | 256-389-9800
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Fax | 256-389-1594
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Provider Business Mailing Address
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Address Line | 859 E HOBSON ST
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City | TUSCUMBIA
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State | AL
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Zip | 35674-1428
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Country | US
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Telephone | 256-389-9800
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Fax | 256-389-1594
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Authorized Official
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Title or Position | PHARMACIST/OWNER
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Name | LEE KENNEDY
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Credential | PHARM.D.
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Telephone | 256-389-9800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336M0002X
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Taxonomy Name | Mail Order 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 | 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 #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 112554
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License Number State | AL
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