# KILGORE EXPRESS PHARMACY INC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** North Jackson Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1497769491
- **Authorized official:** LOTHA LEE KILGORE (OWNER)
- **Authorized official phone:** (256) 845-6640

## Contact information

- **Practice address:** 85 BANK ST, STEVENSON, AL 35772-3781
- **Practice address phone:** (256) 437-2248
- **Practice address fax:** (256) 437-9003
- **Mailing address:** PO BOX 680905, FORT PAYNE, AL 35968-1610
- **Mailing address phone:** (256) 437-2248
- **Mailing address fax:** (256) 437-9003

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | 107218 | AL | Yes |

## Other

- **Enumeration date:** 07/28/2006
- **Last updated:** 12/31/2019

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100002584 | — | AL |
| 01 | — | 1992953 | PK | — |