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General NPI Number Information
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NPI Number | 1245320290
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Entity Type | Organization
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Legal Business Name | MARROWBONE CLINIC PHARMACY
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Dates
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Enumeration Date | 10/13/2006
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Last Update Date | 05/19/2008
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Provider Practice Location Address
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Address Line | 10363 REGINA BELCHER HWY
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City | REGINA
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State | KY
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Zip | 41559
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Country | US
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Telephone | 606-754-7085
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Fax | 606-754-9218
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Provider Business Mailing Address
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Address Line | PO BOX 225
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City | REGINA
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State | KY
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Zip | 41559-0225
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | JAMES HUFFMAN
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Credential | RPH
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Telephone | 606-754-7085
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 | KY
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Taxonomy #2
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Taxonomy Code | 3336C0002X
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Taxonomy Name | Clinic Pharmacy
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License Number | PO1360
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License Number State | KY
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