Organization
KING KULLEN PHARMACY
Active
Parent organization
KING KULLEN GROCERY CO. INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
KING KULLEN GROCERY CO. INC.
Authorized official
ALBERT HESSE RPH (PHARMACY COORDINTOR)
(516) 733-7100
Entity
Organization
Contact information
Practice address
795 OLD COUNTRY RD, RIVERHEAD, NY 11901-2111
(631) 727-6085
(631) 208-4005
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
022520
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01581259
—
NY
01
—
3305427
OTHER ID NUMBER
—
Enumeration date
01/08/2007
Last updated
02/24/2009
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