Provider Demographics
NPI:1033438312
Name:KC PHARMACY
Entity Type:Organization
Organization Name:KC PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST IN CHARGE
Authorized Official - Prefix:DR
Authorized Official - First Name:KINGSLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:CADMUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-722-6960
Mailing Address - Street 1:5430 N TRYON ST
Mailing Address - Street 2:SUITE 16
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28213-7128
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5430 N TRYON ST
Practice Address - Street 2:SUITE 16
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28213-7128
Practice Address - Country:US
Practice Address - Phone:704-399-4817
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GLOBAL NETWORKS SERVICES OF THE CAROLINAS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-05-25
Last Update Date:2010-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy