Organization
ELY DRUGS INC
Active
Organization
ELY DRUGS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRAVIS K. HUDNALL (PRESIDENT)
(270) 651-5159
Entity
Organization
Contact information
Practice address
415 HAPPY VALLEY RD, GLASGOW, KY 42141-1537
(270) 651-8359
Mailing address
415 HAPPY VALLEY RD, GLASGOW, KY 42141-1537
(270) 651-8359
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
012590
KY
333600000X
Pharmacy
P00704
KY
3336C0003X
Community/Retail Pharmacy
Primary
POO704
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
54008651
—
KY
Enumeration date
07/06/2006
Last updated
04/17/2015
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