Provider Demographics
NPI:1043373673
Name:KINSER DRUGS INC
Entity Type:Organization
Organization Name:KINSER DRUGS INC
Other - Org Name:KINSER DRUGS INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARM AND OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CAMERON
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMBY
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:865-376-5157
Mailing Address - Street 1:142 E CUMBERLAND ST
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:TN
Mailing Address - Zip Code:37763-2811
Mailing Address - Country:US
Mailing Address - Phone:865-376-5157
Mailing Address - Fax:865-376-1272
Practice Address - Street 1:142 E CUMBERLAND ST
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:TN
Practice Address - Zip Code:37763-2811
Practice Address - Country:US
Practice Address - Phone:865-376-5157
Practice Address - Fax:865-376-1272
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-18
Last Update Date:2017-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
TN5153336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN9440413Medicaid
2095612OtherPK
4155510001Medicare NSC