Organization
KINGDOM PHARMACY LLC
Active
Organization
KINGDOM PHARMACY LLC
Active
Other names
Kingdom Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MARTINE KOUAHOU (MANAGER)
(484) 455-7915
Entity
Organization
Contact information
Practice address
9014 W CHESTER PIKE, UPPER DARBY, PA 19082-2606
(484) 455-7915
(484) 455-7923
Mailing address
9014 W CHESTER PIKE, UPPER DARBY, PA 19082-2606
(484) 455-7915
(484) 455-7923
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PP482480
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1029193710001
—
PA
01
—
2145885
PK
—
Enumeration date
05/21/2014
Last updated
11/29/2016
Update your record
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