Organization
WOODBURN PHARMACY, LLC
Active
Organization
WOODBURN PHARMACY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL L KELLER PHARMD, RPH (MEMBER)
(270) 797-2010
Entity
Organization
Contact information
Practice address
400 E ARCADIA AVE, DAWSON SPRINGS, KY 42408-1638
(270) 797-2761
(270) 797-3473
Mailing address
400 E ARCADIA AVE, DAWSON SPRINGS, KY 42408-1638
(270) 797-2761
(270) 797-3473
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
PO6539
KY
3336C0003X
Community/Retail Pharmacy
Primary
PO6539
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1804411
NABP
KY
05
—
54000757
—
KY
05
—
90008194
—
KY
Enumeration date
10/03/2006
Last updated
02/08/2017
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