Provider Demographics
NPI:1285933440
Name:KING, JAMES KENNETH (RPH)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:KENNETH
Last Name:KING
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:139 WATERSIDE CIR
Mailing Address - Street 2:
Mailing Address - City:WINFIELD
Mailing Address - State:WV
Mailing Address - Zip Code:25213-9551
Mailing Address - Country:US
Mailing Address - Phone:304-553-8808
Mailing Address - Fax:
Practice Address - Street 1:100 21ST ST
Practice Address - Street 2:
Practice Address - City:NITRO
Practice Address - State:WV
Practice Address - Zip Code:25143-1740
Practice Address - Country:US
Practice Address - Phone:304-755-3391
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-26
Last Update Date:2011-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVRP0005834183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist