Healthcare Provider Details

I. General information

NPI: 1699983510
Provider Name (Legal Business Name): RX DISCOUNT PHARMACY OF KNOX COUNTY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2007
Last Update Date: 02/13/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 TREUHAFT BLVD
BARBOURVILLE KY
40906
US

IV. Provider business mailing address

P.O. BOX 1569
HAZARD KY
41702
US

V. Phone/Fax

Practice location:
  • Phone: 606-277-0577
  • Fax: 606-277-0578
Mailing address:
  • Phone: 606-436-2407
  • Fax: 606-436-0727

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberP07173
License Number StateKY

VIII. Authorized Official

Name: THERESA L MULLINS
Title or Position: CONTRACT CO. ADMIN
Credential:
Phone: 606-436-2407