Provider Demographics
NPI:1851935688
Name:K-PACK PHARMACY
Entity Type:Organization
Organization Name:K-PACK PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PIC
Authorized Official - Prefix:DR
Authorized Official - First Name:ALMA
Authorized Official - Middle Name:
Authorized Official - Last Name:KILLPACK
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:307-871-9764
Mailing Address - Street 1:170 COMMERCE DR STE B
Mailing Address - Street 2:
Mailing Address - City:GREEN RIVER
Mailing Address - State:WY
Mailing Address - Zip Code:82935-6156
Mailing Address - Country:US
Mailing Address - Phone:307-875-6722
Mailing Address - Fax:307-466-4181
Practice Address - Street 1:170 COMMERCE DR STE B
Practice Address - Street 2:
Practice Address - City:GREEN RIVER
Practice Address - State:WY
Practice Address - Zip Code:82935-6156
Practice Address - Country:US
Practice Address - Phone:307-875-6722
Practice Address - Fax:307-466-4181
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-05
Last Update Date:2022-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy