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General NPI Number Information
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NPI Number | 1508111782
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Entity Type | Organization
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Legal Business Name | EAST KENTUCKY DRUG INC.
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Dates
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Enumeration Date | 07/13/2012
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Last Update Date | 10/22/2025
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Provider Practice Location Address
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Address Line | 160 CONN ST STE 2
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City | IVEL
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State | KY
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Zip | 41642-9406
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Country | US
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Telephone | 606-478-3784
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Fax | 606-478-3788
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Provider Business Mailing Address
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Address Line | PO BOX 155
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City | IVEL
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State | KY
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Zip | 41642-0155
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Country | US
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Telephone | 606-478-3784
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Fax | 606-478-3788
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Authorized Official
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Title or Position | PRESIDENT
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Name | ROBIN JUSTICE
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Credential | PHARMD
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Telephone | 606-478-3784
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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 | P07512
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License Number State | KY
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