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General NPI Number Information
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NPI Number | 1609924653
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Entity Type | Organization
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Legal Business Name | FELCO INCORPORATED
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Dates
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Enumeration Date | 01/08/2007
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Last Update Date | 06/15/2021
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Provider Practice Location Address
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Address Line | 2160 BLACKLOG RD SUITE 100
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City | INEZ
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State | KY
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Zip | 41224
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Country | US
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Telephone | 606-298-7283
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Fax | 606-298-4538
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Provider Business Mailing Address
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Address Line | PO BOX 1305
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City | INEZ
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State | KY
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Zip | 41224-1305
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. LON E LAFFERTY
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Credential | M.D.
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Telephone | 606-298-7283
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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 |
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License Number State |
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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 | P07734
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License Number State | KY
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