Organization
EDMONSON DRUG COMPANY INC
Active
Organization
EDMONSON DRUG COMPANY INC
Active
Other names
EDMONSON DRUG Co.
Organization subpart
No
Provider details
NPI number
Authorized official
TREVOR RAY PHARMD (OWNER/SECRETARY)
(270) 597-2386
Entity
Organization
Contact information
Practice address
100 PARK PLACE, STE 8, BROWNSVILLE, KY 42210-0058
(270) 597-2386
(844) 682-8099
Mailing address
PO BOX 58, BROWNSVILLE, KY 42210-0058
(270) 597-2386
(844) 682-8099
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
P07681
KY
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2028554
PK
—
05
—
7100384270
—
KY
Enumeration date
07/25/2006
Last updated
12/07/2018
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