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General NPI Number Information
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NPI Number | 1881791549
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Entity Type | Organization
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Legal Business Name | KINGS PHARMACY LLC
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Dates
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Enumeration Date | 09/17/2006
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Last Update Date | 06/12/2013
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Provider Practice Location Address
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Address Line | 33 PARK AVE
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City | NEWARK
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State | NJ
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Zip | 07104-1043
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Country | US
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Telephone | 973-482-1556
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Fax | 973-482-1594
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Provider Business Mailing Address
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Address Line | PO BOX 304
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City | CEDAR GROVE
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State | NJ
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Zip | 07009-0304
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Country | US
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Telephone | 973-482-1556
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Fax | 973-482-1594
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. GEORGE E. MALEK
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Credential | R.PH.
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Telephone | 973-482-1556
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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 | 28RS00528200
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number | 28RS00528200
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty Pharmacy
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License Number | 28RS00528200
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License Number State | NJ
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