Kenneth David Gaskins
Individual provider Active NPI Pharmacist · Zebulon, GA
NPI 1043352271 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1043352271
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 14242 (GA)
- Practice address
- 119 Concord Street
Zebulon, GA 30295 - Phone
- (770) 567-8844
- Fax
- (770) 567-5222
- NPI assigned
- Feb 13, 2007
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14242 | GA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| City Pharmacy of Zebulon PC | Current | Accepting new patients | |
| City Pharmacy of Zebulon PC | Current | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 14242 | GA | Yes |
Addresses
Primary practice location
119 Concord Street
Zebulon, GA 30295
Mailing address
370 Peachbelt Rd
Thomaston, GA 30286-5472
Phone (706) 647-8253
Other providers in Zebulon, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.