Organization
KB PHARMACY
Active
Other names
KB Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
BRADLEY BOONE PHARM D (MEMBER)
(270) 967-9007
Entity
Organization
Contact information
Practice address
320 S MAIN ST, MARION, KY 42064-1513
(270) 967-9007
Mailing address
320 S MAIN ST, PO BOX 437, MARION, KY 42064-1513
(270) 967-9007
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PO7465
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PO7465
LICENSE
KY
Enumeration date
08/17/2011
Last updated
03/16/2021
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