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General NPI Number Information
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NPI Number | 1639216013
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Entity Type | Organization
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Legal Business Name | PRESCRIPTION SHOPPE INC
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Dates
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Enumeration Date | 02/01/2007
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Last Update Date | 01/27/2012
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Provider Practice Location Address
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Address Line | 808 JAMESTOWN ST
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City | COLUMBIA
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State | KY
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Zip | 42728-1010
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Country | US
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Telephone | 270-384-2132
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Fax | 270-384-4541
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Provider Business Mailing Address
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Address Line | 808 JAMESTOWN ST
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City | COLUMBIA
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State | KY
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Zip | 42728-1010
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Country | US
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Telephone | 270-384-2132
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Fax | 270-384-4541
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Authorized Official
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Title or Position | OWNER
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Name | MICHAEL LEE STEPHENS
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Credential | R.PH.
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Telephone | 270-384-2132
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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 | P01056
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | P01056
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License Number State | KY
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