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General NPI Number Information
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NPI Number | 1477187334
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Entity Type | Organization
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Legal Business Name | BARBOURVILLE PRESCRIPTION CENTER, LLC
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Dates
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Enumeration Date | 02/28/2020
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Last Update Date | 05/06/2020
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Provider Practice Location Address
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Address Line | 1881 SOUTH U.S. HIGHWAY 25E
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City | BARBOURVILLE
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State | KY
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Zip | 40906
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Country | US
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Telephone | 606-546-6337
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Fax | 606-546-6339
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Provider Business Mailing Address
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Address Line | PO BOX 1390
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City | BARBOURVILLE
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State | KY
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Zip | 40906-5390
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Country | US
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Telephone | 606-546-6337
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Fax | 606-546-6339
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Authorized Official
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Title or Position | OWNER/MEMBER
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Name | DR. DANIEL GLEN THIES
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Credential | PHARMD.
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Telephone | 606-599-3500
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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 |
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License Number State |
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