Organization
PHARMACY SERVICES OF CAMPBELLSVILLE
Active
Other names
THE MEDICINE CENTRE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
EDWARD BAISE PBS (PHARMACIST AND OWNER)
(270) 465-3784
Entity
Organization
Contact information
Practice address
325 E BROADWAY ST, CAMPBELLSVILLE, KY 42718-2003
(270) 465-3784
(270) 789-3784
Mailing address
325 E BROADWAY ST, CAMPBELLSVILLE, KY 42718-2003
(270) 465-3784
(270) 789-3784
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
P01893
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2030601
PK
—
05
—
54020631
—
KY
Enumeration date
09/30/2006
Last updated
11/10/2015
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