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General NPI Number Information
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NPI Number | 1801829221
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Entity Type | Organization
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Legal Business Name | KENLY DRUG & PHARMACY INC
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Dates
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Enumeration Date | 07/09/2006
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Last Update Date | 05/18/2017
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Provider Practice Location Address
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Address Line | 104 E 2ND ST
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City | KENLY
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State | NC
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Zip | 27542-7791
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Country | US
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Telephone | 919-284-2333
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Fax | 919-284-2717
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Provider Business Mailing Address
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Address Line | PO BOX 147
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City | KENLY
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State | NC
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Zip | 27542-0147
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Country | US
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Telephone | 919-284-2333
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ROBIN DAVIS
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Credential | RPH
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Telephone | 919-284-2333
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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 | 08155
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License Number State | NC
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