Healthcare Provider Details

I. General information

NPI: 1780138511
Provider Name (Legal Business Name): PHARMACY CARE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2016
Last Update Date: 08/10/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 TOWN AND COUNTRY LN SUITE 101
HAZARD KY
41701-9524
US

IV. Provider business mailing address

101 TOWN AND COUNTRY LN SUITE 101
HAZARD KY
41701-9524
US

V. Phone/Fax

Practice location:
  • Phone: 606-435-0460
  • Fax: 606-435-0461
Mailing address:
  • Phone: 606-435-0460
  • Fax: 606-435-0461

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License NumberPO7662
License Number StateKY

VIII. Authorized Official

Name: MRS. CHARLA NAPIER
Title or Position: COO
Credential:
Phone: 606-439-1300