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General NPI Number Information
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NPI Number | 1194152041
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Entity Type | Organization
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Legal Business Name | KILLEEN PHARMACY
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Dates
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Enumeration Date | 10/07/2013
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Last Update Date | 08/01/2014
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Provider Practice Location Address
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Address Line | 218 E AVENUE B
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City | KILLEEN
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State | TX
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Zip | 76541-5223
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Country | US
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Telephone | 254-247-3979
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Fax |
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Provider Business Mailing Address
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Address Line | 218 E AVENUE B
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City | KILLEEN
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State | TX
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Zip | 76541-5223
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Country | US
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Telephone | 254-247-3979
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ZIZI NGUYEN
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Credential |
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Telephone | 267-257-4622
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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 |
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License Number State |
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