Organization
KEVIN CONCANNON LLC
Active
Parent organization
KEVIN CONCANNON LLC
Other names
Lifeline Pharmacy 1
Organization subpart
Yes
Provider details
NPI number
Legal business name
KEVIN CONCANNON LLC
Authorized official
KEVIN CONCANNON (CEO)
(520) 730-7575
Entity
Organization
Contact information
Practice address
2500 W TRENTON RD STE 12, EDINBURG, TX 78539-8023
(520) 730-7575
Mailing address
4840 E SALIDA DEL SOL PL, TUCSON, AZ 85718-5410
(520) 730-7575
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Enumeration date
11/03/2022
Last updated
11/03/2022
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