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General NPI Number Information
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NPI Number | 1134165152
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Entity Type | Organization
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Legal Business Name | BIG SANDY HEALTH CARE INC
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Dates
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Enumeration Date | 06/20/2006
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Last Update Date | 02/28/2025
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Provider Practice Location Address
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Address Line | 178 DOUGLAS PKWY SHELBY VALLEY CLINIC PHARMACY
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City | PIKEVILLE
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State | KY
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Zip | 41501-6970
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Country | US
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Telephone | 606-639-3136
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Fax | 606-653-1166
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Provider Business Mailing Address
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Address Line | 1709 KY ROUTE 321 SUITE 3 BIG SANDY HEALTH CARE INC
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City | PRESTONSBURG
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State | KY
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Zip | 41653-9101
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Country | US
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Telephone | 606-886-8546
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Fax | 606-886-8548
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Authorized Official
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Title or Position | CEO
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Name | MR. JAMES HERALD
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Credential |
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Telephone | 606-886-8546
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0002X
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Taxonomy Name | Clinic Pharmacy
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License Number | P06965
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License Number State | KY
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