Healthcare Provider Details

I. General information

NPI: 1073865408
Provider Name (Legal Business Name): BISHOP PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2012
Last Update Date: 02/10/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

486 N HIGHWAY 25 W
WILLIAMSBURG KY
40769-1560
US

IV. Provider business mailing address

PO BOX 598
WILLIAMSBURG KY
40769-0598
US

V. Phone/Fax

Practice location:
  • Phone: 606-515-6134
  • Fax: 606-515-6093
Mailing address:
  • Phone: 606-515-6134
  • Fax: 606-515-6093

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number171230
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberP07525
License Number StateKY

VIII. Authorized Official

Name: JAMES RICKETT
Title or Position: PHARMACIST/OWNER
Credential:
Phone: 606-515-6134