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General NPI Number Information
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NPI Number | 1578826327
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Entity Type | Organization
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Legal Business Name | MEDI-K INC
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Dates
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Enumeration Date | 06/18/2012
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Last Update Date | 02/24/2015
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Provider Practice Location Address
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Address Line | 2202 US HIGHWAY 258N
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City | KINSTON
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State | NC
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Zip | 28504-7223
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Country | US
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Telephone | 252-522-2200
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Fax | 252-522-2202
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Provider Business Mailing Address
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Address Line | 2202 HWY 250 N
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City | KINSTON
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State | NC
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Zip | 28504
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Country | US
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Telephone | 252-522-2200
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Fax | 252-522-2202
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Authorized Official
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Title or Position | RPH/PRESIDENT
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Name | DALTON ANGE
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Credential |
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Telephone | 252-522-0353
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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 | 11293
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License Number State | NC
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