Organization
KING KULLEN PHARMACIES CORP
Active
Other names
KING KULLEN PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MR. J DONALD KENNEDY (TREASURER DIRECTOR)
(516) 733-7147
Entity
Organization
Contact information
Practice address
4343 AMBOY RD, STATEN ISLAND, NY 10312
(718) 984-6073
(718) 984-3607
Mailing address
185 CENTRAL AVE, BETHPAGE, NY 11714
(516) 733-7196
(516) 827-6263
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
028811
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02965328
—
NY
01
—
3357680
NCPDP
NY
01
—
3357680
OTHER ID NUMBER
—
Enumeration date
04/11/2008
Last updated
05/04/2010
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