KLH Enterprises, Inc.

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHRE008778 Issued in GA

Legal business name

KLH ENTERPRISES, INC.

Practice address

111 N Oakley Dr
Columbus, GA 31906-4476

Phone

(706) 685-1845

Fax

(706) 685-9066

NPI assigned

Dec 28, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Kenneth Lydell Harrell

Title

President

Phone

(706) 685-1845

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• St. Mary's Road Pharmacy Former legal business name

Locations

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1284595200000",
    "number": "1073679684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 N OAKLEY DR",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319064476",
            "telephone_number": "706-685-1845",
            "fax_number": "706-685-9066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 N OAKLEY DR",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319064476",
            "telephone_number": "706-685-1845",
            "fax_number": "706-685-9066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KLH ENTERPRISES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-28",
        "last_updated": "2010-09-16",
        "status": "A",
        "authorized_official_last_name": "HARRELL",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "LYDELL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "706-685-1845",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "GA",
            "license": "PHRE008778",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "265721575A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St. Mary's Road Pharmacy",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Andrea Kittle, RBT
• Pamela M. Kittrell, LPC
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• Kla Medical Services, Inc.
• Hanna Kleinschmidt
• Jena Klinker, DPT
• KLJ Community Service Inc
• Maureen E Kloap, PA-C
• KMC Family Care PC
• KMC Urgent Care PC

• Community/Retail Pharmacy in Columbus, GA
• Providers in Columbus, GA by specialty
• Community/Retail Pharmacy in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2010; 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.