Provider Demographics
NPI:1568831071
Name:2-K PHARMAKON SERVICES LLC
Entity Type:Organization
Organization Name:2-K PHARMAKON SERVICES LLC
Other - Org Name:TWIN CITY DRUG CO.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:BRANT
Authorized Official - Last Name:KICKLIGHTER
Authorized Official - Suffix:JR
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:478-763-2151
Mailing Address - Street 1:PO BOX 1040
Mailing Address - Street 2:
Mailing Address - City:TWIN CITY
Mailing Address - State:GA
Mailing Address - Zip Code:30471-1040
Mailing Address - Country:US
Mailing Address - Phone:478-763-2151
Mailing Address - Fax:478-763-3833
Practice Address - Street 1:507 S RAILROAD AVE
Practice Address - Street 2:
Practice Address - City:TWIN CITY
Practice Address - State:GA
Practice Address - Zip Code:30471
Practice Address - Country:US
Practice Address - Phone:478-763-2151
Practice Address - Fax:478-763-3833
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-15
Last Update Date:2015-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPHRE0101733336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy