Provider Demographics
NPI:1922796788
Name:KING VENTURE PLLC
Entity Type:Organization
Organization Name:KING VENTURE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:AARON
Authorized Official - Last Name:KING
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:806-731-4825
Mailing Address - Street 1:PO BOX 719
Mailing Address - Street 2:
Mailing Address - City:CLAUDE
Mailing Address - State:TX
Mailing Address - Zip Code:79019-0719
Mailing Address - Country:US
Mailing Address - Phone:806-731-4825
Mailing Address - Fax:
Practice Address - Street 1:100 TRICE ST UNIT A
Practice Address - Street 2:
Practice Address - City:CLAUDE
Practice Address - State:TX
Practice Address - Zip Code:79019-3908
Practice Address - Country:US
Practice Address - Phone:806-731-4825
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-28
Last Update Date:2023-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy