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General NPI Number Information
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NPI Number | 1376762146
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Entity Type | Organization
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Legal Business Name | MEDICAL CENTER PHARMACY, INC.
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Dates
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Enumeration Date | 04/24/2007
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 1010 MEDICAL CENTER DR
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City | POWDERLY
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State | KY
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Zip | 42367-5463
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Country | US
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Telephone | 270-684-3414
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Fax | 270-684-3414
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Provider Business Mailing Address
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Address Line | 1010 MEDICAL CENTER DR
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City | POWDERLY
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State | KY
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Zip | 42367-5463
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Country | US
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Telephone | 270-684-3414
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Fax | 270-684-3414
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Authorized Official
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Title or Position | SECRETARY
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Name | MRS. ELIZABETH ANN GENTRY
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Credential | RPH
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Telephone | 270-338-9993
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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 | P06622
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License Number State | KY
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