Organization
EPHRAIM MCDOWELL LIBERTY PHARMACY
Active
Organization
EPHRAIM MCDOWELL LIBERTY PHARMACY
Active
Other names
Wellness First Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOAN B HALTOM PHARMD (DIRECTOR OF PHARMACY SERVICES)
(859) 239-1721
Entity
Organization
Contact information
Practice address
68 HUSTONVILLE STREET, LIBERTY, KY 42539-3456
(859) 239-1721
Mailing address
217 SOUTH THIRD STREET, DEPT OF PHARMACY, DANVILLE, KY 40422-8911
(859) 239-1721
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
P07029
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
54011507
—
KY
Enumeration date
08/24/2006
Last updated
04/17/2012
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