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NPI Code Detail

MEDICARE: HIGHLAND PHARMACY INC.

MEDICARE: HIGHLAND PHARMACY INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1332BP3500XParenteral & Enteral Nutrition Supplies (DME)P07492KY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1215287057
Entity Type Code : Organization
Provider Name (Legal Business Name) : HIGHLAND PHARMACY INC.
Provider Business Mailing Address
First Line : 301 ROGERS RD
Second Line :
City : GLASGOW
State : KY
Zip : 42141-4110
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 301 ROGERS RD
Second Line :
City : GLASGOW
State : KY
Zip : 42141-4110
Country : US
Telephone Number : 270-629-4300
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : DR. TRAVIS HUDNALL
Credential :
Telephone Number : 270-651-5159
Provider Enumeration Date : 09/19/2012
Last Update Date : 09/19/2012

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