Organization
KING KULLEN PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALBERT HESSE RPH (PHARMACY COORDINATOR)
(516) 733-7100
Entity
Organization
Contact information
Practice address
231 W MERRICK RD, VALLEY STREAM, NY 11580-5514
(516) 593-1505
(516) 593-2294
Mailing address
KING KULLEN GROCRY CO INC, 185 CENTRAL AVE DEPT 1030, BETHPAGE, NY 11714-3929
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
025582
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2375097
—
NY
01
—
3329617
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
01/08/2007
Last updated
09/12/2007
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