NPIMap

Organization Active NPI

Kilgore Express Pharmacy Inc

Doing business as North Jackson Pharmacy

  • Community/Retail Pharmacy
  • Stevenson, AL
National Provider Identifier
1497769491
Registry record updated Dec 31, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
107218 Issued in AL
Legal business name
KILGORE EXPRESS PHARMACY INC
Doing business as
North Jackson Pharmacy
Practice address
85 Bank St
Stevenson, AL 35772-3781
Phone
(256) 437-2248
Fax
(256) 437-9003
NPI assigned
Jul 28, 2006
Last updated
Dec 31, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2019

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

Authorized official

Name
Lotha Lee KilgoreNPI 1083253876
Title
Owner
Phone
(256) 845-6640

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 107218 AL Primary

Addresses

Primary practice location

85 Bank St
Stevenson, AL 35772-3781

Mailing address

PO Box 680905
Fort Payne, AL 35968-1610
Phone (256) 437-2248

Other names 1

  • North Jackson Pharmacy Doing business as

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

85 Bank St
Stevenson, AL 35772
Phone (256) 437-2248

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1577750400000",
    "number": "1497769491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 680905",
            "city": "FORT PAYNE",
            "state": "AL",
            "postal_code": "359681610",
            "telephone_number": "256-437-2248",
            "fax_number": "256-437-9003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 BANK ST",
            "city": "STEVENSON",
            "state": "AL",
            "postal_code": "357723781",
            "telephone_number": "256-437-2248",
            "fax_number": "256-437-9003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KILGORE EXPRESS PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-28",
        "last_updated": "2019-12-31",
        "certification_date": "2019-12-31",
        "status": "A",
        "authorized_official_last_name": "KILGORE",
        "authorized_official_first_name": "LOTHA",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "256-845-6640"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "AL",
            "license": "107218",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North Jackson Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Stevenson, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2019; 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.