Provider Demographics
NPI:1821117581
Name:TAYLOR, KENNETH SCOTT (RPH)
Entity Type:Individual
Prefix:MR
First Name:KENNETH
Middle Name:SCOTT
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5620 HARTFIELD DOWNS DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28269-7171
Mailing Address - Country:US
Mailing Address - Phone:704-947-2877
Mailing Address - Fax:
Practice Address - Street 1:2420 SUPERCENTER DR NE
Practice Address - Street 2:
Practice Address - City:KANNAPOLIS
Practice Address - State:NC
Practice Address - Zip Code:28083-6426
Practice Address - Country:US
Practice Address - Phone:704-792-9830
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-27
Last Update Date:2014-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC14583183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist