Provider Demographics
NPI:1740204296
Name:KING, CHARLES COUTURE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:COUTURE
Last Name:KING
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 MUIR RD
Mailing Address - Street 2:PHARMACY SERVICE (119)
Mailing Address - City:MARTINEZ
Mailing Address - State:CA
Mailing Address - Zip Code:94553-4668
Mailing Address - Country:US
Mailing Address - Phone:925-372-2380
Mailing Address - Fax:925-372-2169
Practice Address - Street 1:150 MUIR RD
Practice Address - Street 2:PHARMACY SERVICE (119)
Practice Address - City:MARTINEZ
Practice Address - State:CA
Practice Address - Zip Code:94553-4668
Practice Address - Country:US
Practice Address - Phone:925-372-2380
Practice Address - Fax:925-372-2169
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2007-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH 46251183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist