Organization
C D S 10 PHARMACY LLC
Active
Organization
C D S 10 PHARMACY LLC
Active
Other names
CDS #10 PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD LACEFIELD (OWNER PHARMACIST)
(270) 781-5661
Entity
Organization
Contact information
Practice address
1308 ASHLEY CIR, BOWLING GREEN, KY 42104-3339
(270) 781-5661
(270) 781-5652
Mailing address
1308 ASHLEY CIR, BOWLING GREEN, KY 42104-3339
(270) 781-5661
(270) 781-5652
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
P00972
KY
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2029251
PK
—
05
—
7100179220
—
KY
Enumeration date
08/18/2006
Last updated
12/23/2019
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