Healthcare Provider Details

I. General information

NPI: 1104824424
Provider Name (Legal Business Name): PHARMACY-CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/11/2005
Last Update Date: 10/28/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

803 BURKESVILLE ST
COLUMBIA KY
42728-1655
US

IV. Provider business mailing address

803 BURKESVILLE ST
COLUMBIA KY
42728-1655
US

V. Phone/Fax

Practice location:
  • Phone: 270-384-2117
  • Fax: 270-384-5636
Mailing address:
  • Phone: 270-384-2117
  • Fax: 270-384-5636

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: BRITTAIN COLE JACKSON
Title or Position: OWNER
Credential: PHARMD
Phone: 270-250-9800