Healthcare Provider Details

I. General information

NPI: 1619061025
Provider Name (Legal Business Name): EUBANK INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

920 JAMESTOWN ST
COLUMBIA KY
42728-1012
US

IV. Provider business mailing address

920 JAMESTOWN ST
COLUMBIA KY
42728-1012
US

V. Phone/Fax

Practice location:
  • Phone: 270-384-4474
  • Fax: 270-384-9553
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License NumberPO6687
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License NumberP06687
License Number StateKY
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: DAVID EUBANK
Title or Position: OWNER PHARMACIST
Credential: RPH
Phone: 270-384-4474