Healthcare Provider Details

I. General information

NPI: 1528073111
Provider Name (Legal Business Name): CITIZENS DRUG INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2006
Last Update Date: 09/27/2022
Certification Date: 09/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13380 PHELPS 632 RD
PHELPS KY
41553
US

IV. Provider business mailing address

PO BOX 499
PHELPS KY
41553-0499
US

V. Phone/Fax

Practice location:
  • Phone: 606-456-3446
  • Fax: 606-456-1943
Mailing address:
  • Phone: 606-456-3446
  • Fax: 606-456-1943

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberP01543
License Number StateKY

VIII. Authorized Official

Name: BILLY ROWE
Title or Position: PRESIDENT
Credential:
Phone: 606-433-0555