Healthcare Provider Details

I. General information

NPI: 1942310289
Provider Name (Legal Business Name): CARLISLE DRUG INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

126 E MAIN ST CARLISLE DRUG INC
CARLISLE KY
40311-1154
US

IV. Provider business mailing address

126 E MAIN ST CARLISLE DRUG INC
CARLISLE KY
40311-1154
US

V. Phone/Fax

Practice location:
  • Phone: 859-289-2528
  • Fax: 859-289-2246
Mailing address:
  • Phone: 859-289-2528
  • Fax: 859-289-2246

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License NumberP00817
License Number StateKY

VIII. Authorized Official

Name: THOMAS RUSSELL LAWRENCE
Title or Position: PRES RPH
Credential: RPH
Phone: 859-289-2528