# COAL GROVE PHARMACY INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** COAL GROVE PHARMACY INC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1992740427
- **Authorized official:** JASON PLUMMER RPH (OWNER, PIC)
- **Authorized official phone:** (740) 533-2479

## Contact information

- **Practice address:** 600 MARION PIKE, IRONTON, OH 45638-2963
- **Practice address phone:** (740) 533-2479
- **Practice address fax:** (740) 533-2481
- **Mailing address:** 600 MARION PIKE, IRONTON, OH 45638-2963
- **Mailing address phone:** (740) 533-2479
- **Mailing address fax:** (740) 533-2481

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 021427050 | OH | Yes |
| 3336C0004X | Compounding Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 06/18/2006
- **Last updated:** 03/14/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2080349 | PK | — |
| 05 | — | 2615343 | — | OH |
| 05 | — | 54011481 | — | KY |