Provider Demographics
NPI:1326485137
Name:KILLPACK, ALMA (PHARM D)
Entity Type:Individual
Prefix:
First Name:ALMA
Middle Name:
Last Name:KILLPACK
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:170 COMMERCE DR STE B
Mailing Address - Street 2:
Mailing Address - City:GREEN RIVER
Mailing Address - State:WY
Mailing Address - Zip Code:82935-6156
Mailing Address - Country:US
Mailing Address - Phone:307-875-7622
Mailing Address - Fax:
Practice Address - Street 1:170 COMMERCE DR STE B
Practice Address - Street 2:
Practice Address - City:GREEN RIVER
Practice Address - State:WY
Practice Address - Zip Code:82935-6156
Practice Address - Country:US
Practice Address - Phone:307-875-7622
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-03
Last Update Date:2020-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY3225183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist