Organization
WINDHAM DRUG INC
Active
Other names
WINDHAM DRUG
Organization subpart
No
Provider details
NPI number
Authorized official
JUSTIN SMITH PHARMD (VICE-PRESIDENT)
(606) 549-3636
Entity
Organization
Contact information
Practice address
1605 S HIGHWAY 25 W, WILLIAMSBURG, KY 40769-1610
(606) 549-3636
(606) 549-9155
Mailing address
1605 S HIGHWAY 25 W, WILLIAMSBURG, KY 40769-1610
(606) 549-3636
(606) 549-9155
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
P07247
KY
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2035127
PK
—
05
—
7100037700
—
KY
Enumeration date
04/08/2008
Last updated
01/07/2016
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