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General NPI Number Information
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NPI Number | 1578877940
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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 | 07/28/2010
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Last Update Date | 07/06/2012
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Provider Practice Location Address
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Address Line | 311 BOGLE ST
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City | SOMERSET
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State | KY
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Zip | 42503
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Country | US
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Telephone | 606-451-2112
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Fax | 606-451-2115
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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 | MR. LESLIE SCOTT KING
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Credential | PHARM D
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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 | 333600000X
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Taxonomy Name | Pharmacy
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License Number | P07408
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License Number State | KY
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