Organization
CLARKSON DRUG STORE, INC.
Active
Other names
Clarkson Drug Store
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES WILLIAM MARSHALL RPH (PRESIDENT)
(270) 242-3811
Entity
Organization
Contact information
Practice address
201 MILLERSTOWN ST., CLARKSON, KY 42726-0146
(270) 242-3811
(270) 242-4171
Mailing address
PO BOX 146, CLARKSON, KY 42726-0146
(270) 242-3811
(270) 242-4171
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
P00450
KY
333600000X
Pharmacy
Primary
P00450
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000070017
ANTHEM BC & BS
KY
01
—
1802811
NABP
—
05
—
54002209
—
KY
05
—
90020439
—
KY
Enumeration date
09/28/2006
Last updated
01/21/2009
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