Organization
MARSHALL COUNTY HOSP DISTRICT
Active
Other names
MARSHALL COUNTY HOSPITAL PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
PHYLLIS BLACKWELL RPH (CHIEF CLINICAL OFFICER)
(270) 527-4800
Entity
Organization
Contact information
Practice address
615 OLD SYMSONIA RD, BENTON, KY 42025-5042
(270) 527-4885
(270) 527-4893
Mailing address
PO BOX 630, BENTON, KY 42025-0630
(270) 527-4800
(270) 527-4893
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336I0012X
Institutional Pharmacy
Primary
P05109
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2030096
PK
—
05
—
54025473
—
KY
Enumeration date
08/20/2006
Last updated
02/23/2017
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