Organization
REIDLAND PHARMACY INC
Active
Other names
REIDLAND PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MARSHALL DAVIS RPH (PRESIDENT)
(270) 443-1442
Entity
Organization
Contact information
Practice address
5433 REIDLAND RD, PADUCAH, KY 42003-0954
(270) 898-7313
(270) 898-1999
Mailing address
5433 REIDLAND RD, PADUCAH, KY 42003-0954
(270) 898-7313
(270) 898-1999
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
P06520
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1802277
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
54000153
—
KY
05
—
90000308
—
KY
Enumeration date
08/01/2006
Last updated
09/02/2021
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