Healthcare Provider Details

I. General information

NPI: 1730325127
Provider Name (Legal Business Name): MEDICINE ARTS PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/06/2009
Last Update Date: 12/28/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

818 US 31W BYP
BOWLING GREEN KY
42101-2314
US

IV. Provider business mailing address

818 US 31W BYP
BOWLING GREEN KY
42101-2314
US

V. Phone/Fax

Practice location:
  • Phone: 270-843-3202
  • Fax: 270-782-8181
Mailing address:
  • Phone: 270-843-3202
  • Fax: 270-782-8181

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberP07315
License Number StateKY
# 3
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: WILLIAM BUCY
Title or Position: PHARMACY OWNER
Credential:
Phone: 270-843-3202