Provider Demographics
NPI:1417038985
Name:KENNETH GUIN DRUGS INC
Entity Type:Organization
Organization Name:KENNETH GUIN DRUGS INC
Other - Org Name:KENNETH GUIN DRUGS INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:
Authorized Official - Last Name:GUIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-924-9616
Mailing Address - Street 1:PO BOX 458
Mailing Address - Street 2:
Mailing Address - City:CARBON HILL
Mailing Address - State:AL
Mailing Address - Zip Code:35549-0458
Mailing Address - Country:US
Mailing Address - Phone:205-924-9616
Mailing Address - Fax:205-924-9767
Practice Address - Street 1:31946 1ST AVE NW
Practice Address - Street 2:
Practice Address - City:CARBON HILL
Practice Address - State:AL
Practice Address - Zip Code:35549-5221
Practice Address - Country:US
Practice Address - Phone:205-924-9616
Practice Address - Fax:205-924-9767
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-18
Last Update Date:2015-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
AL1048003336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000050678Medicaid
AL100000628Medicaid
1988599OtherPK
0236960001Medicare NSC