Provider Demographics
NPI:1578005583
Name:KINGSTON, SHAKOLA (PHARM, D)
Entity Type:Individual
Prefix:DR
First Name:SHAKOLA
Middle Name:
Last Name:KINGSTON
Suffix:
Gender:F
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 1:12501 STONE VILLAGE WAY
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23113-2715
Mailing Address - Country:US
Mailing Address - Phone:804-419-9945
Mailing Address - Fax:
Practice Address - Street 1:12501 STONE VILLAGE WAY
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23113-2715
Practice Address - Country:US
Practice Address - Phone:804-419-9945
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-08
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202215423183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist