Provider Demographics
NPI:1225058449
Name:KINGSLEY PHARMACEUTICALS INC.
Entity Type:Organization
Organization Name:KINGSLEY PHARMACEUTICALS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ZALESKI
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:800-662-8572
Mailing Address - Street 1:118 S. BROWNSON AVE
Mailing Address - Street 2:
Mailing Address - City:KINGSLEY
Mailing Address - State:MI
Mailing Address - Zip Code:49649-0367
Mailing Address - Country:US
Mailing Address - Phone:800-662-8572
Mailing Address - Fax:231-263-7925
Practice Address - Street 1:118 S BROWNSON AVE
Practice Address - Street 2:
Practice Address - City:KINGSLEY
Practice Address - State:MI
Practice Address - Zip Code:49649-0367
Practice Address - Country:US
Practice Address - Phone:800-662-8572
Practice Address - Fax:231-263-7925
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5301006778332B00000X, 333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Not Answered333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2358186OtherNCPDP
MI2358186OtherNCPDP