Organization
JEFFS PHARMACY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBEY WALTERS (RPH/OWNER)
(606) 248-0171
Entity
Organization
Contact information
Practice address
120 LOTHBURY AVE, MIDDLESBORO, KY 40965-0954
(606) 248-0171
(606) 248-5455
Mailing address
PO BOX 954, MIDDLESBORO, KY 40965
(606) 248-0171
(606) 248-5455
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
P02176
KY
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2031528
PK
—
05
—
54024500
—
KY
Enumeration date
07/05/2006
Last updated
06/09/2017
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