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General NPI Number Information
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NPI Number | 1346353976
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Entity Type | Organization
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Legal Business Name | KENS PHARMACY INC.
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Dates
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Enumeration Date | 08/17/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 36 ELM ST
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City | MANCHESTER
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State | NH
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Zip | 03101-2724
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Country | US
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Telephone | 603-623-2813
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Fax | 603-626-7308
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Provider Business Mailing Address
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Address Line | 36 ELM ST
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City | MANCHESTER
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State | NH
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Zip | 03101-2724
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Country | US
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Telephone | 603-623-2813
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Fax | 603-626-7308
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Authorized Official
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Title or Position | PRESIDENT
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Name | KEN M GILLIS
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Credential | R.PH.
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Telephone | 603-623-2813
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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 | 293
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License Number State | NH
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