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General NPI Number Information
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NPI Number | 1487718524
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Entity Type | Organization
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Legal Business Name | THE MAYSVILLE PHARMACY
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Dates
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Enumeration Date | 12/21/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1220 FOREST AVE
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City | MAYSVILLE
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State | KY
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Zip | 41056
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Country | US
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Telephone | 606-563-9355
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Fax | 606-563-9305
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Provider Business Mailing Address
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Address Line | 1220 FOREST AVE
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City | MAYSVILLE
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State | KY
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Zip | 41056
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Country | US
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Telephone | 606-563-9355
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Fax | 606-563-9305
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Authorized Official
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Title or Position | MGR
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Name | MR. JAMES LOUIS GALLENSTEIN JR.
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Credential |
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Telephone | 606-563-9355
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | P06460
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License Number State | KY
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