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Organization

MCDONALD PHARMACY INC

Active
Other names
MCDONALD PHARMACY
Organization subpart
No

Provider details

NPI number
Authorized official
DAVID BRADLEY STULTZ RPH (PIC)
(606) 922-5512
Entity
Organization

Contact information

Practice address
437 JAMES E HANNAH DR, SOUTH SHORE, KY 41175-9600
(606) 932-3614
(606) 932-3614
Mailing address
PO BOX 774, SOUTH SHORE, KY 41175-0774
(606) 932-3614

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
333600000X
Pharmacy
3336C0003X
Community/Retail Pharmacy
Primary
P01070
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0391517
OH
01
2029133
PK
05
54014196
KY
Enumeration date
11/07/2006
Last updated
07/26/2021
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