KCL Incorporated

Organization Active NPI Community/Retail Pharmacy · Somerville, TN

NPI 1326210345 · NPPES record last updated Sep 11, 2019

Key facts

NPI
1326210345
Entity type
Organization (NPI type 2)
Primary specialty
Community/Retail Pharmacy 3336C0003X
License
4494 (TN)
Legal business name
KCL INCORPORATED
Practice address
25 Woodbridge Rd Ste B
Ste B
Somerville, TN 38068-1242
Phone
(901) 466-1127
Fax
(901) 466-1126
NPI assigned
Mar 31, 2008
Organization subpart
No

Authorized official

Name
Dr. Cynthia Lou Landry, PHARMD
Title
Owner
Phone
(901) 466-1127

Corporate family (same tax ID) 1

Organizations that report the same tax identification number in the National Provider Directory.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in TN

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20191014003354 TN Part B Supplier - Pharmacy 8820329386 Practice locations: Somerville, TN

National Provider Directory

Tax ID family
KCL Inc (2 organizations share this tax ID)

Locations

25 Woodbridge Rd
Ste B
Somerville, TN 38068
Phone (901) 466-1127

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 4494 TN Yes

Addresses

Primary practice location

25 Woodbridge Rd Ste B
Ste B
Somerville, TN 38068-1242

Mailing address

25 Woodbridge Rd
Ste B
Somerville, TN 38068-1242
Phone (901) 466-1127

Other identifiers

IdentifierTypeStateIssuer
2095356OtherPK

Other names

  • LANDRYS PHARMACY Doing business as

Other providers in Somerville, TN

All providers in Somerville, TN · Community/Retail Pharmacy in Tennessee

Sources for this page

Verify at the official NPI Registry.