Provider Demographics
NPI:1881244937
Name:KING RX, LLC
Entity type:Organization
Organization Name:KING RX, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST-IN-CHARGE
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVITA
Authorized Official - Middle Name:L
Authorized Official - Last Name:BEY
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:484-278-4308
Mailing Address - Street 1:29 BALA AVE STE 114
Mailing Address - Street 2:
Mailing Address - City:BALA CYNWYD
Mailing Address - State:PA
Mailing Address - Zip Code:19004-3206
Mailing Address - Country:US
Mailing Address - Phone:484-278-4308
Mailing Address - Fax:866-840-0033
Practice Address - Street 1:29 BALA AVE STE 114
Practice Address - Street 2:
Practice Address - City:BALA CYNWYD
Practice Address - State:PA
Practice Address - Zip Code:19004-3206
Practice Address - Country:US
Practice Address - Phone:484-278-4308
Practice Address - Fax:866-840-0033
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-19
Last Update Date:2019-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy