Organization
PHARMACY SERVICES OF CAMPBELLSVILLE
Active
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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