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General NPI Number Information
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NPI Number | 1366497984
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Entity Type | Organization
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Legal Business Name | KILMARNOCK DRUG CO INC
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Dates
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Enumeration Date | 05/23/2006
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Last Update Date | 04/11/2017
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Provider Practice Location Address
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Address Line | 2 S MAIN ST
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City | KILMARNOCK
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State | VA
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Zip | 22482
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Country | US
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Telephone | 804-435-2186
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Fax | 844-742-6569
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Provider Business Mailing Address
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Address Line | PO BOX 1898 P.O. BOX 1898
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City | KILMARNOCK
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State | VA
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Zip | 22482-1898
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Country | US
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Telephone | 804-435-2186
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Fax | 844-742-6569
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Authorized Official
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Title or Position | PRESIDENT
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Name | KENNETH THOMPSON
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Credential | BS PHARMACY
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Telephone | 804-435-2186
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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 | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number | 0201002948
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License Number State | VA
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