Provider Demographics
NPI:1851856561
Name:FULTON PHARMACY, INC.
Entity Type:Organization
Organization Name:FULTON PHARMACY, INC.
Other - Org Name:FULTON DRUGS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KRISTINE
Authorized Official - Middle Name:A
Authorized Official - Last Name:KINGSBURY
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:330-832-2226
Mailing Address - Street 1:5713 EAST BLVD NW
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44718-1654
Mailing Address - Country:US
Mailing Address - Phone:330-832-2226
Mailing Address - Fax:330-832-3833
Practice Address - Street 1:1657 25TH ST NW
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44709-3421
Practice Address - Country:US
Practice Address - Phone:330-456-2476
Practice Address - Fax:330-456-1973
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-06
Last Update Date:2020-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy