# KINGSWAY ENT. INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** KINGSWAY PHARMACY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1639232390
- **Authorized official:** DR. RICHMOND G NIMAKO-BOATENG PHARM.D, RPH. (PRESIDENT)
- **Authorized official phone:** (630) 236-9502

## Contact information

- **Practice address:** 1677 MONTGOMERY RD, SUITE 110-112, AURORA, IL 60504-8802
- **Practice address phone:** (630) 236-9502
- **Practice address fax:** (630) 236-9512
- **Mailing address:** 1677 MONTGOMERY RD, SUITE 110-112, AURORA, IL 60504-8802
- **Mailing address phone:** (630) 236-9502
- **Mailing address fax:** (630) 236-9512

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | 054015027 | IL | — |
| 3336C0003X | Community/Retail Pharmacy | 054015027 | IL | Yes |
| 3336C0004X | Compounding Pharmacy | 054015027 | IL | — |
| 335E00000X | Prosthetic/Orthotic Supplier | — | IL | — |

## Other

- **Enumeration date:** 12/17/2006
- **Last updated:** 09/09/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1476426 | NCPDP | — |