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General NPI Number Information
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NPI Number | 1093717043
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Entity Type | Organization
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Legal Business Name | MEDICINE STORE
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Dates
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Enumeration Date | 06/02/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 231 N HIGH ST
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City | HILLSBORO
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State | OH
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Zip | 45133-1128
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Country | US
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Telephone | 937-393-1996
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Fax |
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Provider Business Mailing Address
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Address Line | 231 N HIGH ST
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City | HILLSBORO
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State | OH
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Zip | 45133-1128
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Country | US
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Telephone | 937-393-1996
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Fax |
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Authorized Official
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Title or Position | PHARMACIST/OWNER
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Name | MR. JEFFREY GUY KING
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Credential | R.PH.
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Telephone | 937-393-1996
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State | OH
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