Provider Demographics
NPI:1043359458
Name:KNIGHT PHARMACY INC
Entity Type:Organization
Organization Name:KNIGHT PHARMACY INC
Other - Org Name:EASTMANS PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:KNIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:603-643-4112
Mailing Address - Street 1:22 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:NH
Mailing Address - Zip Code:03755-2015
Mailing Address - Country:US
Mailing Address - Phone:603-643-4112
Mailing Address - Fax:603-643-0367
Practice Address - Street 1:22 S MAIN ST
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:NH
Practice Address - Zip Code:03755-2015
Practice Address - Country:US
Practice Address - Phone:603-643-4112
Practice Address - Fax:603-643-0367
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0667P183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30703621Medicaid
NH30703621Medicaid