Organization
EASTRIDGE-PHELPS PHARMACY LLC
Active
Organization
EASTRIDGE-PHELPS PHARMACY LLC
Active
Other names
Eastridge-Phelps Pharmacy Greensburg
Organization subpart
No
Provider details
NPI number
Authorized official
CHAD PHELPS (MEMBER/PHARMACIST)
(270) 299-2333
Entity
Organization
Contact information
Practice address
460 COMMERCE DR, GREENSBURG, KY 42743-1402
(270) 299-2333
(270) 299-2334
Mailing address
460 COMMERCE DR, GREENSBURG, KY 42743-1402
(270) 299-2333
(270) 299-2334
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
P07439
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2128693
PK
—
05
—
7100149910
—
KY
Enumeration date
02/07/2011
Last updated
06/10/2022
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