Organization
FREDERICK & SMITH INC
Active
Other names
CLINIC PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES FREDERICK RPH (OWNER,AO)
(606) 743-3114
Entity
Organization
Contact information
Practice address
412 LIBERTY RD, WEST LIBERTY, KY 41472-2049
(606) 743-4957
(606) 743-2187
Mailing address
PO BOX 277, WEST LIBERTY, KY 41472-0277
(606) 743-4957
(606) 743-2187
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
P02110
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2030586
PK
—
05
—
54020144
—
KY
05
—
90010885
—
KY
Enumeration date
08/20/2006
Last updated
09/17/2015
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