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General NPI Number Information
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NPI Number | 1942917919
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Entity Type | Organization
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Legal Business Name | KONG GLOBAL, LLC
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Dates
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Enumeration Date | 10/31/2022
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Last Update Date | 10/31/2022
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Provider Practice Location Address
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Address Line | 9601 N BEACH ST STE 105
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City | FORT WORTH
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State | TX
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Zip | 76244-6432
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Country | US
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Telephone | 817-952-1999
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Fax | 817-952-1932
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Provider Business Mailing Address
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Address Line | 9601 N BEACH ST STE 105
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City | FORT WORTH
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State | TX
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Zip | 76244-6432
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Country | US
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Telephone | 817-952-1999
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Fax | 817-952-1932
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Authorized Official
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Title or Position | MANAGER
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Name | TINA KONG
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Credential |
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Telephone | 817-952-1999
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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 |
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License Number State |
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