Malken Pharm Services Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

MALKEN PHARM SERVICES INC

Doing business as

PEMBROKE PHARMACY INC

Practice address

137 E. Bacon St
Pembroke, GA 31321

Phone

(912) 653-2772

Fax

(912) 653-2752

NPI assigned

Mar 9, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Kenneth Brant Kicklighter, PHARMD

Title

President/Owner

Phone

(912) 653-2772

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• PEMBROKE PHARMACY INC Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Chelan Yardman, PHARMD

  • Pharmacist
  • Pembroke, GA
  • NPI 1174416994
  NPD

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

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1590537600000",
    "number": "1366573297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O BOX 1329",
            "city": "PEMBROKE",
            "state": "GA",
            "postal_code": "31321",
            "telephone_number": "912-653-2772",
            "fax_number": "912-653-2752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "137 E. BACON ST",
            "city": "PEMBROKE",
            "state": "GA",
            "postal_code": "31321",
            "telephone_number": "912-653-2772",
            "fax_number": "912-653-2752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MALKEN PHARM SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-09",
        "last_updated": "2020-05-27",
        "certification_date": "2020-05-27",
        "status": "A",
        "authorized_official_last_name": "KICKLIGHTER",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "BRANT",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "912-653-2772",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "GA",
            "license": "PHRE005854",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2013956",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00143822A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PEMBROKE PHARMACY INC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PEMBROKE PHARMACY INC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Karen H Herring, RDMS (AB) (BR)(OBGYN
• Embry Mayes Kendrick, OD
• Alayne Kittle, RN, BSN
• Jennifer Jordan Lander, P. T.
• Aris Jade Lonon
• Janice Palmer, LPN
• Jennifer Creek Poston, PTA
• Quinate Pharmacy LLC
• Janet Denise Rivers
• Saint Josephs Medical Group Inc

• Community/Retail Pharmacy in Pembroke, GA
• Providers in Pembroke, 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 May 27, 2020; 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.