Organization
KING KULLEN PHARMACIES CORP
Active
Other names
King Kullen Pharmacy #11
Organization subpart
No
Provider details
NPI number
Authorized official
ALBERT HESSE RPH (PHARMACY COORDINATOR)
(516) 733-7100
Entity
Organization
Contact information
Practice address
3284 HEMPSTEAD TPKE, LEVITTOWN, NY 11756-1345
(516) 579-2111
(516) 735-5080
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
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
021969
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01458451
—
NY
01
—
3341207
OTHER ID NUMBER
—
Enumeration date
01/08/2007
Last updated
12/08/2017
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