Provider Demographics
NPI:1306532650
Name:KCS PHARMACY LLC
Entity type:Organization
Organization Name:KCS PHARMACY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:STEVENS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:772-475-1463
Mailing Address - Street 1:1130 E DONEGAN AVE STE 13
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34744-1921
Mailing Address - Country:US
Mailing Address - Phone:772-475-1463
Mailing Address - Fax:407-777-8905
Practice Address - Street 1:1130 E DONEGAN AVE STE 13
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34744-1921
Practice Address - Country:US
Practice Address - Phone:772-475-1463
Practice Address - Fax:407-777-8905
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-11
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy