Kilgore Express Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

107218 Issued in AL

Legal business name

KILGORE EXPRESS PHARMACY INC

Practice address

85 Bank St
Stevenson, AL 35772-3781

Phone

(256) 437-2248

Fax

(256) 437-9003

NPI assigned

Jul 28, 2006

Organization subpart

No

Name

Lotha Lee Kilgore

Title

Owner

Phone

(256) 845-6640

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

• Kilgore Express Pharmacy Inc

  • Community/Retail Pharmacy
  • Fort Payne, AL
  • NPI 1609974633

  Member Of

  NPD member

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

• Jennifer Nicole Herrell, PHARMD,

  • Pharmacist
  • Stevenson, AL
  • NPI 1699932780
  NPD (past)
• Steven Thomas Overby, PHARM.D.

  • Nutrition Support Pharmacist
  • Stevenson, AL
  • NPI 1649422767
  NPD (past)
• James Aulton Parker, PHARMD

  • Pharmacist
  • Jasper, TN
  • NPI 1407043011
  NPD (past)

Locations

• North Jackson Pharmacy Doing business as

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Dec 31, 2019.

{
    "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": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100002584",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "1992953",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North Jackson Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Green Medical Group, PC
• Jennifer Nicole Herrell, PHARMD,
• Holland Family Dentistry, LLC
• Mylan Hutchins
• JM Holder
• Ma Mira Inc
• Asha P Mohan, M.D.
• T. Murali Mohan, M.D.
• Amanda Michelle Moore, RESPIRATORY THERAPIS
• William Dywayne Moore, EMT

• All providers in Stevenson, AL
• Community/Retail Pharmacy in Alabama

• 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.