Healthcare Provider Details

I. General information

NPI: 1346234077
Provider Name (Legal Business Name): EXPRESS PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/08/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2800 RADIO RD
ALMO KY
42020-9436
US

IV. Provider business mailing address

2800 RADIO RD
ALMO KY
42020-9436
US

V. Phone/Fax

Practice location:
  • Phone: 270-753-3634
  • Fax: 270-753-3652
Mailing address:
  • Phone: 270-753-3634
  • Fax: 270-753-3652

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License NumberP06953
License Number StateKY

VIII. Authorized Official

Name: DR. RISA D PERRY
Title or Position: OWNER PRESIDENT
Credential: PHARMD
Phone: 270-753-3634