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General NPI Number Information
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NPI Number | 1124089180
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Entity Type | Organization
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Legal Business Name | P I C CORPORATION
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Dates
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Enumeration Date | 03/30/2006
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Last Update Date | 08/14/2015
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Provider Practice Location Address
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Address Line | 60 SLATE AVE
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City | OWINGSVILLE
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State | KY
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Zip | 40360-2201
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Country | US
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Telephone | 606-674-6979
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Fax | 606-674-2637
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Provider Business Mailing Address
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Address Line | PO BOX 1119 60 SLATE AVE.
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City | OWINGSVILLE
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State | KY
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Zip | 40360-1119
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Country | US
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Telephone | 606-674-6979
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Fax | 606-674-2637
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Authorized Official
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Title or Position | OWNER,PIC,AO
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Name | MELODIE HAWKINS
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Credential | RPH
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Telephone | 606-674-6979
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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 |
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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | P01897
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License Number State | KY
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