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General NPI Number Information
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NPI Number | 1326451931
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Entity Type | Organization
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Legal Business Name | TAYLOR DRUG STORE, LLC
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Dates
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Enumeration Date | 06/11/2014
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Last Update Date | 10/12/2015
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Provider Practice Location Address
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Address Line | 308 S PINE ST
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City | PINEVILLE
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State | KY
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Zip | 40977-1735
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Country | US
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Telephone | 606-337-8300
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Fax |
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Provider Business Mailing Address
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Address Line | 308 S PINE ST
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City | PINEVILLE
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State | KY
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Zip | 40977-1735
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Country | US
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Telephone | 606-337-8300
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MR. WILLIAM JASON TAYLOR
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Credential | R PH
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Telephone | 606-337-8300
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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 | P07638
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License Number State | KY
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