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Organization

CORUM FAMILY PHARMACY LLC

Active
Other names
Corum Family Pharmacy
Organization subpart
No

Provider details

NPI number
Authorized official
RANDY WINDHAM (OWNER/PHARMACIST)
(606) 599-0505
Entity
Organization

Contact information

Practice address
1668 S HIGHWAY 421, MANCHESTER, KY 40962-7514
(606) 599-0505
(606) 599-0508
Mailing address
1668 S HIGHWAY 421, MANCHESTER, KY 40962-7514
(606) 599-0505
(606) 599-0508

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
3336C0003X
Community/Retail Pharmacy
Primary
PO7555
KY
3336C0004X
Compounding Pharmacy

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2139027
PK
05
7100235820
KY
Enumeration date
02/20/2013
Last updated
06/18/2014
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