Provider Demographics
NPI:1386196616
Name:K & M DRUGS SOLIVITA INC
Entity type:Organization
Organization Name:K & M DRUGS SOLIVITA INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER/RPH
Authorized Official - Prefix:
Authorized Official - First Name:HAITHAM
Authorized Official - Middle Name:
Authorized Official - Last Name:KAKI
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:561-313-4537
Mailing Address - Street 1:395 VILLAGE DR STE C
Mailing Address - Street 2:
Mailing Address - City:POINCIANA
Mailing Address - State:FL
Mailing Address - Zip Code:34759-4012
Mailing Address - Country:US
Mailing Address - Phone:863-496-7927
Mailing Address - Fax:863-675-6048
Practice Address - Street 1:395 VILLAGE DR STE C
Practice Address - Street 2:
Practice Address - City:POINCIANA
Practice Address - State:FL
Practice Address - Zip Code:34759-4012
Practice Address - Country:US
Practice Address - Phone:863-496-7927
Practice Address - Fax:863-675-6048
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-03
Last Update Date:2018-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
FLPH304313336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL019418200Medicaid
2166036OtherPK