Healthcare Provider Details

I. General information

NPI: 1376949362
Provider Name (Legal Business Name): PHARMACY CARE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/18/2014
Last Update Date: 09/17/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

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

IV. Provider business mailing address

101 TOWN AND COUNTRY LN STE 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 Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberP07662
License Number StateKY

VIII. Authorized Official

Name: ANTHONY HURT
Title or Position: PHARMACIST IN CHARGE
Credential:
Phone: 606-435-0460