Organization
DPA, LLC
Active
Other names
DR'S PARK APOTHECARY
Organization subpart
No
Provider details
NPI number
Authorized official
LORIE A ROADEN (PHARMACY MANAGER)
(606) 528-1932
Entity
Organization
Contact information
Practice address
121 BISHOP ST, SUITE 1, CORBIN, KY 40701-1702
(606) 528-1932
(606) 523-9142
Mailing address
121 BISHOP ST, SUITE 1, CORBIN, KY 40701-1702
(606) 528-1932
(606) 523-9142
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PO022
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1804144
OTHER ID NUMBER
—
05
—
54010723
—
KY
05
—
90041187
—
KY
Enumeration date
02/22/2007
Last updated
08/01/2011
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