Organization
DAUGHERTYS DRUG STORE INC
Active
Organization
DAUGHERTYS DRUG STORE INC
Active
Other names
DAUGHERTYS DRUG STORE INC
Organization subpart
No
Provider details
NPI number
Authorized official
KERRY MATHENY RPH (RPH)
(606) 354-2222
Entity
Organization
Contact information
Practice address
4160 S HIGHWAY 27, PINE KNOT, KY 42635
(606) 354-2222
(877) 739-6724
Mailing address
PO BOX 548, PINE KNOT, KY 42635-0548
(606) 354-2222
(877) 739-6724
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
P01040
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2029239
PK
—
05
—
54013933
—
KY
05
—
90007790
—
KY
Enumeration date
10/31/2005
Last updated
08/25/2026
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