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General NPI Number Information
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NPI Number | 1619081601
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Entity Type | Organization
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Legal Business Name | KINGS DAUGHTERS PHARMACY LLC
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Dates
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Enumeration Date | 08/18/2006
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Last Update Date | 03/31/2017
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Provider Practice Location Address
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Address Line | 1905 SW H K DODGEN LOOP
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City | TEMPLE
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State | TX
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Zip | 76502-1814
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Country | US
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Telephone | 254-778-1731
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Fax | 254-791-2266
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Provider Business Mailing Address
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Address Line | 1905 SW H K DODGEN LOOP
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City | TEMPLE
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State | TX
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Zip | 76502-1814
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Country | US
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Telephone | 254-778-1731
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Fax | 254-791-2266
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Authorized Official
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Title or Position | PHARMACIST IN CHARGE
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Name | ANTHONY COLLINS
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Credential | RPH
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Telephone | 254-778-1731
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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 | 127
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License Number State | TX
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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 | 054020107
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number | PH30688
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | Y007118
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License Number State | AZ
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