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General NPI Number Information
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NPI Number | 1629163142
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Entity Type | Organization
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Legal Business Name | MEDICAL ARTS PHARMACY OF GLASGOW, INC.
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Dates
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Enumeration Date | 10/03/2006
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Last Update Date | 11/21/2022
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Provider Practice Location Address
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Address Line | 1220 N RACE ST
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City | GLASGOW
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State | KY
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Zip | 42141-3462
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Country | US
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Telephone | 270-651-7030
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Fax | 270-651-9948
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Provider Business Mailing Address
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Address Line | 1220 NORTH RACE STREET
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City | GLASGOW
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State | KY
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Zip | 42141-3455
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Country | US
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Telephone | 270-651-7030
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Fax | 270-651-9948
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Authorized Official
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Title or Position | OWNER
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Name | DR. TREVOR RAY
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Credential | PHARMD
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Telephone | 270-651-7030
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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 | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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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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