Organization
BERINGER DRUG STORE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATTY LONG (VP)
(386) 698-3737
Entity
Organization
Contact information
Practice address
102 WEST MAIN ST, SUITE A, WARSAW, KY 41095
(859) 567-4678
(859) 567-4674
Mailing address
PO BOX 608, CRESCENT CITY, FL 32112-0608
(859) 567-4678
(859) 567-4674
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
P06107
KY
3336C0003X
Community/Retail Pharmacy
PO6107
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000069795
BCBS
KY
05
—
133453741
—
AR
05
—
2047056
—
OH
01
—
22885
ABP
—
05
—
4582049
—
TN
01
—
5403319600
KYHEALTH CHOICES
KY
05
—
9002039700
—
KY
Enumeration date
02/22/2007
Last updated
12/17/2009
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