# KINGSLEY PHARMACY AND COMPOUNDING CENTER

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** KINGSLEY PHARMACY AND COMPOUNDING CENTER
- **Other names:** KINGSLEY PHARMACY LTC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1073151031
- **Legal business name:** KINGSLEY PHARMACY AND COMPOUNDING CENTER
- **Authorized official:** MR. BRIAN WILLIAM REUTHER RPH (PRESIDENT/RPH)
- **Authorized official phone:** (231) 263-7701

## Contact information

- **Practice address:** 114 S BROWNSON AVE, KINGSLEY, MI 49649-5103
- **Practice address phone:** (231) 263-7701
- **Practice address fax:** (231) 263-7925
- **Mailing address:** PO BOX 247, KINGSLEY, MI 49649-0247

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336L0003X | Long Term Care Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 12/20/2019
- **Last updated:** 12/20/2019