Provider Demographics
NPI:1477368702
Name:KINGDOM PHARMACY LLC
Entity type:Organization
Organization Name:KINGDOM PHARMACY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHANTAL
Authorized Official - Middle Name:S
Authorized Official - Last Name:NKANGNIA-NJOMO
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:202-988-3863
Mailing Address - Street 1:21320 VILLAGE GREEN CIR
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20876-6950
Mailing Address - Country:US
Mailing Address - Phone:240-246-6671
Mailing Address - Fax:
Practice Address - Street 1:2910 MARTIN LUTHER KING JR AVE SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20032-2522
Practice Address - Country:US
Practice Address - Phone:202-988-3863
Practice Address - Fax:202-998-2606
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-12
Last Update Date:2025-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy