Organization
KILGORE EXPRESS PHARMCY INC
Active
Other names
KILGORE EXPRESS PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
LOTHA KILGORE (OWNER)
(256) 845-6640
Entity
Organization
Contact information
Practice address
5999 HIGHWAY 72 E, GURLEY, AL 35748-9460
(256) 776-4430
(256) 776-4523
Mailing address
PO BOX 680905, FORT PAYNE, AL 35968-1610
(256) 845-6640
(256) 845-6796
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
111989
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0134988
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
01/02/2008
Last updated
12/24/2019
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