Organization
BROADWAY CLINIC PHARMACY INC
Active
Other names
MEDICINE CABINET PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
STEVE WILLIAMS (PRESIDENT)
(606) 324-6337
Entity
Organization
Contact information
Practice address
251 S PINE ST, PINEVILLE, KY 40977-1646
(606) 337-3784
(606) 337-3747
Mailing address
251 S PINE ST, PINEVILLE, KY 40977-1646
(606) 337-3784
(606) 337-3747
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
P07366
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1831709
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
12/19/2009
Last updated
11/08/2010
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