Healthcare Provider Details

I. General information

NPI: 1073526158
Provider Name (Legal Business Name): SCIENCE HILL DRUG, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2006
Last Update Date: 12/10/2020
Certification Date: 12/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5775 N HIGHWAY 27
SCIENCE HILL KY
42553-9140
US

IV. Provider business mailing address

5775 N HIGHWAY 27
SCIENCE HILL KY
42553-9140
US

V. Phone/Fax

Practice location:
  • Phone: 606-423-9959
  • Fax:
Mailing address:
  • Phone: 606-423-9959
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License NumberP06496
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberP06496
License Number StateKY

VIII. Authorized Official

Name: TIMOTHY CARNES
Title or Position: OWNER
Credential: RPH
Phone: 270-566-1074