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General NPI Number Information
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NPI Number | 1679947683
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Entity Type | Organization
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Legal Business Name | K & M DRUGS FORT MYERS LLC
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Dates
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Enumeration Date | 11/16/2015
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Last Update Date | 01/22/2016
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Provider Practice Location Address
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Address Line | 14651 PALM BEACH BLVD
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City | FORT MYERS
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State | FL
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Zip | 33905-2331
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Country | US
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Telephone | 239-689-5788
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Fax | 239-689-5822
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Provider Business Mailing Address
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Address Line | 149 W HICKPOCHEE AVE
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City | LABELLE
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State | FL
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Zip | 33935-4753
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Country | US
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Telephone | 863-675-0004
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Fax | 863-675-6048
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Authorized Official
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Title or Position | OWNER, AO
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Name | AYMAN KAKI
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Credential |
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Telephone | 561-301-6686
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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 | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PH29412
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License Number State | FL
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