Organization
CLAYWELL INC
Active
Other names
MEDICA PHARMACY & WELLNESS CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
ALYSON ROBY RPH (PRES/CEO)
(502) 348-6623
Entity
Organization
Contact information
Practice address
202 W STEPHEN FOSTER AVE, BARDSTOWN, KY 40004-1478
(502) 348-6623
(502) 348-7704
Mailing address
202 W STEPHEN FOSTER AVE, BARDSTOWN, KY 40004-1478
(502) 348-6623
(502) 348-7704
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
P01371
KY
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
54000302
—
KY
05
—
90006909
—
KY
Enumeration date
07/16/2006
Last updated
11/29/2021
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