Organization
UPTOWN PHARMACY OF KINGMAN , INC
Active
Other names
UPTOWN DRUG
Organization subpart
No
Provider details
NPI number
Authorized official
CHRIS HOWARD PROFFIT B.S. PHARMACY (OWNER)
(928) 753-2226
Entity
Organization
Contact information
Practice address
2820 E ANDY DEVINE AVE, KINGMAN, AZ 86401-4203
(928) 753-2226
(928) 753-7649
Mailing address
2820 E ANDY DEVINE AVE, KINGMAN, AZ 86401-4203
(928) 753-2226
(928) 753-7649
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
Y007029
AZ
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1988343
PK
—
05
—
235636
—
AZ
Enumeration date
08/10/2006
Last updated
04/05/2022
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