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Organization

PINEVILLE PHARMACY LLC

Active
Other names
Pineville Pharmacy
Organization subpart
No

Provider details

NPI number
Authorized official
ERIC GIBBS (OWNER)
(606) 258-0000
Entity
Organization

Contact information

Practice address
114 N PINE ST, PINEVILLE, KY 40977-1647
(606) 337-3335
(606) 337-3338
Mailing address
114 N PINE ST, PINEVILLE, KY 40977-1647
(606) 337-3335
(606) 337-3338

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
3336C0003X
Community/Retail Pharmacy
Primary
P07320
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1830997
NCPDP PROVIDER IDENTIFICATION NUMBER
Enumeration date
01/26/2009
Last updated
08/24/2011
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