Organization
HIGHLAND PHARMACY INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TRAVIS HUDNALL (PRESIDENT)
(270) 651-5159
Entity
Organization
Contact information
Practice address
301 ROGERS RD, GLASGOW, KY 42141-4110
(270) 629-4300
Mailing address
301 ROGERS RD, GLASGOW, KY 42141-4110
Taxonomy
Speciality
Code
Description
License number
State
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
Primary
P07492
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100186050
—
KY
Enumeration date
09/19/2012
Last updated
09/19/2012
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