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Organization

KING KULLEN PHARMACIES CORP

Active
Parent organization
KING KULLEN GROCERY CO. INC.
Other names
King Kullen Pharmacy #3
Organization subpart
Yes

Provider details

NPI number
Legal business name
KING KULLEN GROCERY CO. INC.
Authorized official
ALBERT HESSE (PHCY COORDINATOR)
(516) 733-7196
Entity
Organization

Contact information

Practice address
31525 MAIN RD, CUTCHOGUE, NY 11935-1343
(631) 734-7733
(631) 734-2193
Mailing address
KING KULLEN GROCERY CO INC, 185 CENTRAL AVE DEPT 1030, BETHPAGE, NY 11714-3929
(516) 733-7100
(516) 827-6263

Taxonomy

Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
018363
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00861885
NY
01
018363
NY STATE PHARMACY LICENSE NUMBER
NY
01
3381249
NCPDP NUMBER
Enumeration date
01/08/2007
Last updated
12/08/2017
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