Organization
BURGESS DRUG STORE INC
Active
Other names
BURGESS DRUGS
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES BALL RPH (OWNER)
(606) 376-5043
Entity
Organization
Contact information
Practice address
19 MEDICAL LOOP, WHITLEY CITY, KY 42653-0309
(606) 376-5043
(606) 376-5466
Mailing address
PO BOX 309, WHITLEY CITY, KY 42653-0309
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
1244
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1809764
OTHER ID NUMBER
—
05
—
54014733
—
KY
Enumeration date
02/07/2007
Last updated
09/13/2007
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