Organization
EXPRESS CARE PHARMACY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RONALD B JACKSON (OWNER)
(606) 599-0340
Entity
Organization
Contact information
Practice address
359 OLD US HIGHWAY 421, MANCHESTER, KY 40962-7538
(606) 599-0340
(606) 599-0349
Mailing address
359 OLD US HIGHWAY 421, MANCHESTER, KY 40962-7538
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100632170
—
KY
Enumeration date
10/15/2019
Last updated
11/24/2021
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