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General NPI Number Information
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NPI Number | 1427153949
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Entity Type | Organization
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Legal Business Name | MONTGOMERY DRUGS, INC
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Dates
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Enumeration Date | 09/13/2006
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Last Update Date | 07/04/2011
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Provider Practice Location Address
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Address Line | 201 S MAIN ST
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City | LEITCHFIELD
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State | KY
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Zip | 42754-1425
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Country | US
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Telephone | 270-259-3125
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Fax | 270-259-0407
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Provider Business Mailing Address
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Address Line | 210 S MAIN ST
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City | LEITCHFIELD
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State | KY
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Zip | 42754-9998
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Country | US
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Telephone | 270-259-3125
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Fax | 270-259-0407
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Authorized Official
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Title or Position | PRES
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Name | WILLIAM D. WOODEN
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Credential | RPH
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Telephone | 270-259-3125
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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 | 00299
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License Number State | KY
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