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General NPI Number Information
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NPI Number | 1124399738
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Entity Type | Organization
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Legal Business Name | PARKWAY PHARMACY, INC.
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Dates
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Enumeration Date | 01/13/2012
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Last Update Date | 06/27/2016
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Provider Practice Location Address
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Address Line | 100 BRENNA BLVD SUITE 200
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City | SALYERSVILLE
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State | KY
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Zip | 41465-9815
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Country | US
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Telephone | 606-349-4400
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Fax | 606-349-4410
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Provider Business Mailing Address
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Address Line | PO BOX 8
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City | SALYERSVILLE
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State | KY
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Zip | 41465-0008
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Country | US
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Telephone | 606-349-4400
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Fax | 606-349-4410
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | JESSE RUDD
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Credential |
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Telephone | 606-226-4444
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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 | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | P07488
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License Number State | KY
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