Provider Demographics
NPI:1851903470
Name:K & D PHARMACY
Entity type:Organization
Organization Name:K & D PHARMACY
Other - Org Name:
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:229-263-4061
Mailing Address - Street 1:19664 VALDOSTA HWY STE A
Mailing Address - Street 2:
Mailing Address - City:VALDOSTA
Mailing Address - State:GA
Mailing Address - Zip Code:31602-8344
Mailing Address - Country:US
Mailing Address - Phone:229-588-4080
Mailing Address - Fax:229-588-4083
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:31602-8344
Practice Address - Country:US
Practice Address - Phone:229-588-4080
Practice Address - Fax:229-588-4083
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-17
Last Update Date:2020-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy