Provider Demographics
NPI:1649767633
Name:K&K PHARMACY INC.
Entity Type:Organization
Organization Name:K&K PHARMACY INC.
Other - Org Name:K&K PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER / PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:KRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:ISAACSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-392-1300
Mailing Address - Street 1:1411 W AMERICAN BLVD
Mailing Address - Street 2:
Mailing Address - City:MULESHOE
Mailing Address - State:TX
Mailing Address - Zip Code:79347-3123
Mailing Address - Country:US
Mailing Address - Phone:806-272-7511
Mailing Address - Fax:806-272-7515
Practice Address - Street 1:1411 W AMERICAN BLVD
Practice Address - Street 2:
Practice Address - City:MULESHOE
Practice Address - State:TX
Practice Address - Zip Code:79347-3123
Practice Address - Country:US
Practice Address - Phone:806-272-7511
Practice Address - Fax:806-272-7515
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-16
Last Update Date:2020-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
TX274883336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2177017OtherPK