Organization
GRANT COUNTY DRUGS-NORTH
Active
Organization
GRANT COUNTY DRUGS-NORTH
Active
Other names
Grant County Drugs - North
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT JASON WALLACE PHARM.D.,R.PH (OWNER/PHARMACIST)
(859) 823-5271
Entity
Organization
Contact information
Practice address
375 VIOLET RD, CRITTENDEN, KY 41030-8535
(859) 428-3784
(859) 428-0595
Mailing address
24 S MAIN ST, P.O. BOX 106, DRY RIDGE, KY 41035-7329
(859) 823-5271
(859) 428-0595
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
P07334
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100068010
—
KS
Enumeration date
03/24/2009
Last updated
05/02/2025
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