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General NPI Number Information
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NPI Number | 1528092756
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Entity Type | Organization
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Legal Business Name | WAYNE KWIKSCRIPT, INC.
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Dates
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Enumeration Date | 07/11/2006
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Last Update Date | 01/18/2011
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Provider Practice Location Address
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Address Line | 1251 COLUMBIA AVENUE
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City | MONTICELLO
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State | KY
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Zip | 42633-1677
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Country | US
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Telephone | 606-348-4455
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Fax | 606-348-4717
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Provider Business Mailing Address
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Address Line | 1251 COLUMBIA AVENUE
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City | MONTICELLO
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State | KY
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Zip | 42633-1677
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Country | US
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Telephone | 606-348-4455
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Fax | 606-348-4717
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Authorized Official
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Title or Position | OWNER
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Name | MRS. BETINA GREGORY
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Credential |
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Telephone | 606-348-4455
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 9001116400
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | P07238
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License Number State | KY
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