Organization
US 25W PHARMACY INC
Active
Other names
US 25W Pharmacy Inc
Organization subpart
No
Provider details
NPI number
Authorized official
LARRY KENNETH (PHARMACY MANAGER)
(606) 258-7024
Entity
Organization
Contact information
Practice address
1610 CUMBERLAND FALLS HWY, STE 9, CORBIN, KY 40701-2777
(606) 258-7024
(606) 258-7098
Mailing address
1610 CUMBERLAND FALLS HWY, STE 9, CORBIN, KY 40701-2777
Taxonomy
Speciality
Code
Description
License number
State
3336M0002X
Mail Order Pharmacy
Primary
P07323
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1831115
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
03/18/2009
Last updated
03/18/2009
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