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General NPI Number Information
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NPI Number | 1740397876
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Entity Type | Organization
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Legal Business Name | CLAY DRUG STORE INC
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Dates
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Enumeration Date | 08/24/2006
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Last Update Date | 09/03/2015
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Provider Practice Location Address
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Address Line | 9055 ST RT 132 W
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City | CLAY
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State | KY
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Zip | 42404
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Country | US
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Telephone | 270-664-2270
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Fax | 270-664-6633
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Provider Business Mailing Address
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Address Line | PO BOX 8
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City | CLAY
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State | KY
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Zip | 42404-0008
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Country | US
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Telephone | 270-664-2270
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Fax | 270-664-6633
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Authorized Official
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Title or Position | OWNER,PIC,AO
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Name | WHITNEY WRIGHT
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Credential | RPH
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Telephone | 270-664-2270
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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 | P06492
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License Number State | KY
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