Provider Demographics
NPI:1225621196
Name:KKP HOLDINGS LLC
Entity Type:Organization
Organization Name:KKP HOLDINGS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:WILHITE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-734-3146
Mailing Address - Street 1:2104 AL HIGHWAY 157
Mailing Address - Street 2:
Mailing Address - City:CULLMAN
Mailing Address - State:AL
Mailing Address - Zip Code:35058-0656
Mailing Address - Country:US
Mailing Address - Phone:256-734-3146
Mailing Address - Fax:256-734-2179
Practice Address - Street 1:2104 AL HIGHWAY 157
Practice Address - Street 2:
Practice Address - City:CULLMAN
Practice Address - State:AL
Practice Address - Zip Code:35058-0656
Practice Address - Country:US
Practice Address - Phone:256-734-3146
Practice Address - Fax:256-734-2179
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KKP HOLDINGS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-02-11
Last Update Date:2021-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy