Provider Demographics
NPI:1588125785
Name:K & D PHARMACY INC
Entity type:Organization
Organization Name:K & D PHARMACY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KASEY
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:KNIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:229-588-4080
Mailing Address - Street 1:302 E SCREVEN ST
Mailing Address - Street 2:
Mailing Address - City:QUITMAN
Mailing Address - State:GA
Mailing Address - Zip Code:31643-2178
Mailing Address - Country:US
Mailing Address - Phone:912-223-6326
Mailing Address - Fax:
Practice Address - Street 1:19664 VALDOSTA HWY STE A
Practice Address - Street 2:
Practice Address - City:VALDOSTA
Practice Address - State:GA
Practice Address - Zip Code:31602-8300
Practice Address - Country:US
Practice Address - Phone:229-588-4080
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:K & D PHARMACY INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-03-29
Last Update Date:2019-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy