NPIMap

Organization Active NPI

Kilgore Express Pharmacy Inc

Doing business as Kilgore Express Pharmacy #6

  • Community/Retail Pharmacy
  • Fort Payne, AL
National Provider Identifier
1730415142
Registry record updated Oct 20, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
113311 Issued in AL
Legal business name
KILGORE EXPRESS PHARMACY INC
Doing business as
Kilgore Express Pharmacy #6
Practice address
1614 Glenn Blvd SW
Fort Payne, AL 35968-3522
Phone
(256) 845-3402
Fax
(256) 845-3289
NPI assigned
Oct 20, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2009

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

Authorized official

Name
Lotha KilgoreNPI 1083253876
Title
Pharmacist/Owner
Phone
(256) 845-3402

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 113311 AL Primary

Addresses

Primary practice location

1614 Glenn Blvd SW
Fort Payne, AL 35968-3522

Mailing address

PO Box 680905
Fort Payne, AL 35968-1610
Phone (256) 845-6640

Other identifiers 1

IdentifierTypeStateIssuer
0136209OtherNCPDP PROVIDER IDENTIFICATION NUMBER

Other names 1

  • Kilgore Express Pharmacy #6 Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Kilgore Express Pharmacy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

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": "1255996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1255996800000",
    "number": "1730415142",
    "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": "256-845-6640",
            "fax_number": "256-845-9796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1614 GLENN BLVD SW",
            "city": "FORT PAYNE",
            "state": "AL",
            "postal_code": "359683522",
            "telephone_number": "256-845-3402",
            "fax_number": "256-845-3289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KILGORE EXPRESS PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-20",
        "last_updated": "2009-10-20",
        "status": "A",
        "authorized_official_last_name": "KILGORE",
        "authorized_official_first_name": "LOTHA",
        "authorized_official_title_or_position": "PHARMACIST/OWNER",
        "authorized_official_telephone_number": "256-845-3402"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "AL",
            "license": "113311",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "0136209",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kilgore Express Pharmacy #6",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Payne, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2009; 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.