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General NPI Number Information
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NPI Number | 1407199854
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Entity Type | Organization
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Legal Business Name | CENTRAL KENTUCKY PHARMACY INC
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Dates
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Enumeration Date | 04/04/2013
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Last Update Date | 05/08/2013
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Provider Practice Location Address
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Address Line | 111 W FLAGET ST
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City | BARDSTOWN
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State | KY
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Zip | 40004-1422
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Country | US
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Telephone | 502-348-3938
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Fax | 502-348-3434
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Provider Business Mailing Address
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Address Line | 111 W FLAGET ST
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City | BARDSTOWN
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State | KY
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Zip | 40004-1422
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Country | US
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Telephone | 502-348-3938
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Fax | 502-348-3434
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Authorized Official
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Title or Position | PRESIDENT
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Name | ROBBIN SIZEMORE
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Credential |
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Telephone | 502-507-5489
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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 | P07567
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License Number State | KY
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