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General NPI Number Information
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NPI Number | 1336441484
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Entity Type | Organization
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Legal Business Name | KING PHARMACY INC
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Dates
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Enumeration Date | 11/23/2010
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Last Update Date | 10/17/2018
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Provider Practice Location Address
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Address Line | 22320 MAIN ST
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City | HYDEN
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State | KY
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Zip | 41749-8571
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Country | US
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Telephone | 606-672-2210
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Fax | 606-672-2297
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Provider Business Mailing Address
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Address Line | 900 MORTON BLVD
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City | HAZARD
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State | KY
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Zip | 41701-9476
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Country | US
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Telephone | 606-435-1067
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Fax | 606-435-1073
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Authorized Official
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Title or Position | OWNER
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Name | LESLIE KING
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Credential |
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Telephone | 606-435-1067
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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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Taxonomy #2
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | P07424
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License Number State | KY
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