Organization
FULTON ROAD PHARMACY INC
Active
Other names
FULTON DRUGS
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY KINGSBURY RPH (PRESIDENT)
(330) 456-2476
Entity
Organization
Contact information
Practice address
1657 25TH ST NW, CANTON, OH 44709-3421
(330) 456-2476
(330) 456-1973
Mailing address
1657 25TH ST NW, CANTON, OH 44709-3421
(330) 456-2476
(330) 456-1973
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
021296900
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2078516
PK
—
05
—
2286477
—
OH
Enumeration date
10/25/2006
Last updated
12/01/2016
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