Organization
WEST KINGMAN PHARMACY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KASSIE LYNN VILLA CPHT (PHARMACY MANAGER)
(928) 377-1350
Entity
Organization
Contact information
Practice address
3135 N STOCKTON HILL RD, KINGMAN, AZ 86401
(928) 377-1350
Mailing address
1099 SUNRISE AVE, KINGMAN, AZ 86401-6825
(928) 718-4852
(928) 718-4856
Taxonomy
Speciality
Code
Description
License number
State
3336C0002X
Clinic Pharmacy
4696
AZ
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Enumeration date
03/22/2007
Last updated
03/11/2020
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