Organization
BRODHEAD PHARMACY INC
Active
Other names
BRODHEAD PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID COLLINS (OWNER/PRESIDENT)
(606) 758-4373
Entity
Organization
Contact information
Practice address
54 W MAIN ST, BRODHEAD, KY 40409-8890
(606) 758-4373
(606) 758-4764
Mailing address
PO BOX 527, BRODHEAD, KY 40409-0527
(606) 758-4373
(606) 758-4764
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
P06727
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2033827
PK
—
05
—
54002985
—
KY
Enumeration date
12/27/2006
Last updated
06/02/2015
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