Healthcare Provider Details

I. General information

NPI: 1346820198
Provider Name (Legal Business Name): ELKHORN PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/14/2021
Last Update Date: 04/14/2021
Certification Date: 04/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 E ELKHORN ST
ELKHORN CITY KY
41522-8558
US

IV. Provider business mailing address

220 E ELKHORN ST
ELKHORN CITY KY
41522-8558
US

V. Phone/Fax

Practice location:
  • Phone: 606-754-5076
  • Fax:
Mailing address:
  • Phone: 606-754-5076
  • Fax:

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: SARAH BELL
Title or Position: PRESIDENT
Credential:
Phone: 859-552-0734