Pembroke Pharmacy Inc

LBN: Malken Pharm Services Inc
Pembroke Pharmacy Inc is an health care organization with primary practice located at 137 E. Bacon St , Pembroke GA 31321. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Malken Pharm Services Inc can be contacted via phone (912) 653-2772, or through Kicklighter, Kenneth Brant via phone (912) 653-2772.

Contact Information

Primary practice address
137 E. Bacon St Pembroke GA 31321
Phone: (912) 653-2772
Fax: (912) 653-2752
Website:
Map and Directions
Authorized official contact:
Name: Kicklighter, Kenneth Brant PHARMD
Phone: (912) 653-2772

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X PHRE005854 Georgia
Suppliers / Community/Retail Pharmacy 3336C0003X

Profile Details

NPI number 1366573297
LBN Legal business name Malken Pharm Services Inc
DBA Doing business as Pembroke Pharmacy Inc
Authorized official Kicklighter, Kenneth Brant PHARMD
Entity Organization
Organization subpart 1 No
Enumeration date Mar 9th, 2007
Last updated May 27th, 2020 - about 6 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1366573297 NPPES
Other 2013956 PK
MEDICAID 00143822A PK

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