Organization
BROADWAY CLINIC PHARMACY INC
Active
Other names
MEDICINE CABINET PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
STEVE WILLIAMS (PRESIDENT)
(859) 225-3784
Entity
Organization
Contact information
Practice address
698 E NEW CIRCLE RD, LEXINGTON, KY 40505-2948
(859) 225-3784
(859) 381-0277
Mailing address
698 E NEW CIRCLE RD, LEXINGTON, KY 40505-2948
(859) 225-3784
(859) 381-0277
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
P07419
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1832357
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
03/29/2011
Last updated
05/02/2011
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