Organization
EDMONSON DRUG COMPANY INC
Active
Parent organization
MIDWAY PHARMACY OF CLARKSON, INC.
Other names
Edmonson Drug Co.
Organization subpart
Yes
Provider details
NPI number
Legal business name
MIDWAY PHARMACY OF CLARKSON, INC.
Authorized official
DR. TREVOR RAY PHARMD (SECRETARY)
(270) 597-2386
Entity
Organization
Contact information
Practice address
100 PARK PLACE, STE 8, BROWNSVILLE, KY 42210-0058
(270) 597-2386
(844) 682-8099
Mailing address
100 PARK PLACE , STE 8, PO BOX 58, BROWNSVILLE, KY 42210-0058
(270) 597-2386
(844) 682-8099
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
P07681
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9002031400
—
KY
Enumeration date
03/01/2007
Last updated
12/07/2018
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