King Kullen Pharmacies Corp

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

020241 Issued in NY

Legal business name

KING KULLEN PHARMACIES CORP

Doing business as

King Kullen Pharmacy #18

Practice address

5507 200 Nesconset Hwy
Mount Sinai, NY 11766-2019

Phone

(631) 474-0012

Fax

(631) 473-8515

NPI assigned

Jan 8, 2007

Organization subpart

Yes

Parent organization

KING KULLEN GROCERY CO. INC.As reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Albert Hesse, RPH

Title

Pharmacy Coordinator

Phone

(516) 733-7100

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• King Kullen Pharmacy #18 Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1512691200000",
    "number": "1063560027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "KING KULLEN GROCERY CO INC",
            "address_2": "185 CENTRAL AVE DEPT 1030",
            "city": "BETHPAGE",
            "state": "NY",
            "postal_code": "117143929",
            "telephone_number": "516-733-7100",
            "fax_number": "516-827-6263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5507 200 NESCONSET HWY",
            "city": "MOUNT SINAI",
            "state": "NY",
            "postal_code": "117662019",
            "telephone_number": "631-474-0012",
            "fax_number": "631-473-8515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KING KULLEN PHARMACIES CORP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KING KULLEN GROCERY CO. INC.",
        "enumeration_date": "2007-01-08",
        "last_updated": "2017-12-08",
        "status": "A",
        "authorized_official_last_name": "HESSE",
        "authorized_official_first_name": "ALBERT",
        "authorized_official_title_or_position": "PHARMACY COORDINATOR",
        "authorized_official_telephone_number": "516-733-7100",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "020241",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER",
            "identifier": "3394741",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01143457",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "3394741",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "King Kullen Pharmacy #18",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tiffany Rose Kehoe, LCSW
• Jonathan Robert Kelly, LMSW
• Maureen Kelly, LMSW
• Komal Khiani, MD
• Gina Marie Kiernan
• Bridgette L Knight, RN
• Vicki Denise Knight, MSW, LMCH
• Carl Korpi
• Eileen Korpi
• Bridgette Kovler

• Community/Retail Pharmacy in Mount Sinai, NY
• Providers in Mount Sinai, NY by specialty
• Community/Retail Pharmacy in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.