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Organization

CENTRAL CITY CLINIC PHARMACY, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
RAYMOND DARREL GENTRY D.O. (PHARMACIST)
(270) 476-3600
Entity
Organization

Contact information

Practice address
3901 US HWY 41 S, BEECHMONT, KY 42323
(270) 476-3600
(270) 476-3100
Mailing address
3901 U.S. HWY 41 S., BEECHMONT, KY 42323
(270) 476-3600
(270) 476-3100

Taxonomy

Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1824475
NABP #
KY
05
54032167
KY
Enumeration date
02/09/2007
Last updated
03/07/2023
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