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General NPI Number Information
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NPI Number | 1760789861
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Entity Type | Organization
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Legal Business Name | DRIVE IN PHARMACY INCORPORATED
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Dates
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Enumeration Date | 02/25/2011
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Last Update Date | 05/14/2012
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Provider Practice Location Address
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Address Line | 688 S HIGHWAY 25 W
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City | WILLIAMSBURG
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State | KY
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Zip | 40769-1697
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Country | US
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Telephone | 606-549-0888
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Fax | 606-549-3217
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Provider Business Mailing Address
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Address Line | PO BOX 460
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City | WILLIAMSBURG
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State | KY
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Zip | 40769-0460
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Country | US
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Telephone | 606-549-0888
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Fax | 606-549-3217
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Authorized Official
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Title or Position | OWNER
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Name | MR. RICHARD L. L HARRIS SR.
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Credential |
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Telephone | 606-549-0812
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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 | MG0497
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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 | P07019
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License Number State | KY
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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 | P07019
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License Number State | KY
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