Organization
CARTER PHARMACIST GROUP
Active
Other names
Carter Family Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TOM MATTINGLY RPH (PCI)
(606) 286-2029
Entity
Organization
Contact information
Practice address
136 JESSICA LANE, SUITE E, OLIVE HILL, KY 41164
(606) 286-2029
Mailing address
PO BOX 757, OLIVE HILL, KY 41164-0757
(606) 286-2029
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
P06896
—
333600000X
Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
54005798
—
KY
Enumeration date
10/17/2006
Last updated
09/21/2012
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