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Organization
COAL GROVE PHARMACY INC
Active
Organization
COAL GROVE PHARMACY INC
Active
Other names
COAL GROVE PHARMACY INC
Organization subpart
No
Provider details
NPI number
Authorized official
JASON PLUMMER RPH (OWNER, PIC)
(740) 533-2479
Entity
Organization
Contact information
Practice address
600 MARION PIKE, IRONTON, OH 45638-2963
(740) 533-2479
(740) 533-2481
Mailing address
600 MARION PIKE, IRONTON, OH 45638-2963
(740) 533-2479
(740) 533-2481
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
021427050
OH
3336C0004X
Compounding Pharmacy
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2080349
PK
—
05
—
2615343
—
OH
05
—
54011481
—
KY
Enumeration date
06/18/2006
Last updated
03/14/2016
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