Organization
MIDWAY PHARMACY OF CLARKSON INC
Active
Other names
MIDWAY PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
TREVOR RAY PHARM D (SECRETARY)
(270) 259-8400
Entity
Organization
Contact information
Practice address
1085 WILLIAM THOMASON BYWAY, LEITCHFIELD, KY 42754-1479
(270) 259-8400
(844) 607-4498
Mailing address
1085 WILLIAM THOMASON BYWAY, LEITCHFIELD, KY 42754-1479
(270) 259-8400
(844) 607-4498
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PO6582
KY
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2033412
PK
—
05
—
7100165120
—
KY
Enumeration date
12/26/2005
Last updated
02/03/2026
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