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Organization
KILGORE EXPRESS PHARMCY INC
Active
Organization
KILGORE EXPRESS PHARMCY INC
Active
Other names
KILGORE EXPRESS PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
LOTHA KILGORE RPH (OWNER)
(256) 845-6640
Entity
Organization
Contact information
Practice address
588 S VALLEY AVE, COLLINSVILLE, AL 35961-3535
(256) 524-2981
(256) 524-2987
Mailing address
PO BOX 680905, FORT PAYNE, AL 35968-1610
(256) 845-6640
(256) 845-9796
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
112980
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0134700
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
08/22/2007
Last updated
05/23/2011
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