Provider Demographics
NPI:1467467019
Name:MEDISAVE INC
Entity Type:Organization
Organization Name:MEDISAVE INC
Other - Org Name:KING'S PHARMACY & COMPOUNDING LAB
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SECRETARY/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HAROLD
Authorized Official - Middle Name:
Authorized Official - Last Name:KING
Authorized Official - Suffix:
Authorized Official - Credentials:RPH,CDM
Authorized Official - Phone:910-452-7098
Mailing Address - Street 1:PO BOX 485
Mailing Address - Street 2:
Mailing Address - City:WRIGHTSVILLE BEACH
Mailing Address - State:NC
Mailing Address - Zip Code:28480-0485
Mailing Address - Country:US
Mailing Address - Phone:910-452-7098
Mailing Address - Fax:910-452-7091
Practice Address - Street 1:2231 S COLLEGE RD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-5546
Practice Address - Country:US
Practice Address - Phone:910-452-7098
Practice Address - Fax:910-452-7091
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-30
Last Update Date:2016-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 333600000X, 3336C0004X
NC053043336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC655779Medicaid
2070258OtherPK
NC7700871Medicaid
0649100001Medicare NSC
2T31126AMedicare PIN