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General NPI Number Information
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NPI Number | 1124231485
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Entity Type | Organization
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Legal Business Name | MARTINS PHARMACY
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Dates
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Enumeration Date | 05/07/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3800 ALEXANDRIA PIKE
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City | COLD SPRING
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State | KY
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Zip | 41076-1715
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Country | US
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Telephone | 859-441-5181
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Fax | 859-441-5549
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Provider Business Mailing Address
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Address Line | 3800 ALEXANDRIA PIKE
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City | COLD SPRING
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State | KY
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Zip | 41076-1715
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Country | US
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Telephone | 859-441-5181
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Fax | 859-441-5549
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Authorized Official
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Title or Position | OWNER
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Name | MR. CLARENCE MARTIN
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Credential | RPH
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Telephone | 859-441-5181
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 00283
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License Number State | KY
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