West Kingman Pharmacy Llc

LBN: West Kingman Pharmacy Llc
West Kingman Pharmacy Llc is an health care organization with primary practice located at 3135 N Stockton Hill Rd , Kingman AZ 86401. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. West Kingman Pharmacy Llc can be contacted via phone (928) 718-5418, or through Villa, Kassie Lynn via phone (928) 377-1350.

Contact Information

Primary practice address
3135 N Stockton Hill Rd Kingman AZ 86401
Phone: (928) 718-5418
Fax: (928) 718-5419
Website:
Map and Directions
Authorized official contact:
Name: Villa, Kassie Lynn CPHT
Phone: (928) 377-1350

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X

Profile Details

NPI number 1760878821
LBN Legal business name West Kingman Pharmacy Llc
DBA Doing business as
Authorized official Villa, Kassie Lynn CPHT
Entity Organization
Organization subpart 1 No
Enumeration date Apr 15th, 2015
Last updated Aug 12th, 2019 - about 6 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1760878821 NPPES
Other 2151367 PK
MEDICAID 192215 PK

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