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General NPI Number Information
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NPI Number | 1740555390
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Entity Type | Organization
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Legal Business Name | DANVILLE DRUG COMPANY
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Dates
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Enumeration Date | 03/15/2012
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Last Update Date | 05/24/2012
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Provider Practice Location Address
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Address Line | 135 E MAIN ST STE A
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City | DANVILLE
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State | KY
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Zip | 40422-1637
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Country | US
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Telephone | 859-236-5750
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2928
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City | MIDDLESBORO
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State | KY
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Zip | 40965-4928
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Country | US
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Telephone | 606-269-6129
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ADAM BOWLING
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Credential |
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Telephone | 606-269-6129
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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 | P07494
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License Number State | KY
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