Organization
BUSHONG FAMILY PHARMACY
Active
Other names
Bushong Family Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MARY COURTNEY BUSHONG PHARMD (OWNER)
(615) 970-8903
Entity
Organization
Contact information
Practice address
709 N MAIN ST, TOMPKINSVILLE, KY 42167
(270) 407-5045
(270) 407-5051
Mailing address
709 N MAIN ST, TOMPKINSVILLE, KY 42167-1129
(270) 407-5045
(270) 407-5051
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
332BC3200X
Customized Equipment (DME)
—
—
333600000X
Pharmacy
Primary
—
—
3336C0003X
Community/Retail Pharmacy
P07788
KY
3336C0003X
Community/Retail Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2163593
PK
—
05
—
7100429700
—
KY
Enumeration date
09/01/2016
Last updated
09/01/2020
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