Organization
MEDICAL CENTER PHARMACY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ELIZABETH ANN GENTRY RPH (SECRETARY)
(270) 338-9993
Entity
Organization
Contact information
Practice address
1010 MEDICAL CENTER DR, POWDERLY, KY 42367-5463
(270) 684-3414
(270) 684-3414
Mailing address
1010 MEDICAL CENTER DR, POWDERLY, KY 42367-5463
(270) 684-3414
(270) 684-3414
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
P06622
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9000350000
—
KY
01
—
P06622
STORE LICENSE PERMIT
KY
01
—
SALES & USE TAX
222728
KY
Enumeration date
04/24/2007
Last updated
03/07/2023
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