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General NPI Number Information
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NPI Number | 1659382166
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Entity Type | Organization
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Legal Business Name | CENTRAL DRUG CENTER
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Dates
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Enumeration Date | 08/10/2006
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Last Update Date | 04/15/2008
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Provider Practice Location Address
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Address Line | 102 CENTRAL SHOPPING CTR
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City | CAMPBELLSVILLE
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State | KY
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Zip | 42718-1857
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Country | US
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Telephone | 270-465-4137
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Fax | 270-465-9761
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Provider Business Mailing Address
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Address Line | 102 CENTRAL SHOPPING CTR
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City | CAMPBELLSVILLE
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State | KY
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Zip | 42718-1857
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Country | US
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Telephone | 270-465-4137
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Fax | 270-465-9761
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Authorized Official
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Title or Position | PRESIDENT
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Name | MITCHEL R COX
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Credential |
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Telephone | 270-465-4137
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 007598
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License Number State | KY
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Taxonomy #3
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | P01333
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License Number State | KY
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