Healthcare Provider Details
I. General information
NPI: 1467507277
Provider Name (Legal Business Name): GLASGOW PRESCRIPTION CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/24/2007
Last Update Date: 08/31/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
615 S L ROGERS WELLS BLVD
GLASGOW KY
42141-1074
US
IV. Provider business mailing address
615 S L ROGERS WELLS BLVD
GLASGOW KY
42141-1074
US
V. Phone/Fax
- Phone: 270-651-5133
- Fax: 270-651-6198
- Phone: 270-651-5133
- Fax: 270-651-6198
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | P01120 |
| License Number State | KY |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336L0003X |
| Taxonomy | Long Term Care Pharmacy |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
CHARLES
OLIVER
Title or Position: PRESIDENT
Credential:
Phone: 270-651-5133