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General NPI Number Information
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NPI Number | 1992104442
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Entity Type | Organization
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Legal Business Name | SILVERS HOMETOWN PHARMACY LLC
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Dates
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Enumeration Date | 08/21/2014
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Last Update Date | 02/14/2025
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Provider Practice Location Address
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Address Line | 1251 W COLUMBIA AVE
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City | MONTICELLO
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State | KY
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Zip | 42633-3177
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Country | US
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Telephone | 606-343-0101
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Fax | 606-343-0041
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Provider Business Mailing Address
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Address Line | 1251 W COLUMBIA AVE
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City | MONTICELLO
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State | KY
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Zip | 42633-3177
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Country | US
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Telephone | 606-343-0101
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Fax | 606-343-0041
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | MR. BRYCE A CHILDERS
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Credential | PHARMD
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Telephone | 606-343-0101
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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 | P07645
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License Number State | KY
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