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NPI Code Detail

MEDICARE: KINGS WELLNESS INC

MEDICARE: KINGS WELLNESS INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QM1300XMulti-Specialty Clinic/Center
23336C0002XClinic Pharmacy
3207QG0300XGeriatric Medicine (Family Medicine) Physician

General Provider Information

NPI Number : 1164376521
Entity Type Code : Organization
Provider Name (Legal Business Name) : KINGS WELLNESS INC
Provider Business Mailing Address
First Line : 7043 YANKEE RD
Second Line :
City : LIBERTY TOWNSHIP
State : OH
Zip : 45044-9132
Country : US
Telephone Number : 513-804-3266
Fax Number : 800-565-3179
Provider Business Practice Location Address
First Line : 7043 YANKEE RD
Second Line :
City : LIBERTY TOWNSHIP
State : OH
Zip : 45044-9132
Country : US
Telephone Number : 513-222-7721
Fax Number : 513-964-9053
Authorized Official
Title or Position : OWNER
Name : TATUM KING
Credential : PHARMD
Telephone Number : 513-240-4167
Provider Enumeration Date : 02/23/2026
Last Update Date : 05/20/2026

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Directions to “KINGS WELLNESS INC ” Practice Location

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