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Organization

BLUEGRASS MEDICAL SUPPLY INC TT

Active
Other names
The Medicine Shoppe #586
Organization subpart
No

Provider details

NPI number
Authorized official
DOUGLAS COYLE (PRESIDENT)
(859) 238-0002
Entity
Organization

Contact information

Practice address
636 S COLLEGE ST, HARRODSBURG, KY 40330-2142
(859) 734-4314
(859) 734-4370
Mailing address
900 HUSTONVILLE RD, DANVILLE, KY 40422-2137
(859) 516-4522
(859) 734-4370

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
3336C0003X
Community/Retail Pharmacy
Primary
P07368
KY
3336L0003X
Long Term Care Pharmacy

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2122941
PK
05
4590576700
KY
05
54024773
KY
05
7100089810
KY
Enumeration date
10/02/2006
Last updated
05/23/2016
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