Organization
KYVA INVESTMENTS INC
Active
Other names
KYVA PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
BERNARDINE MIRACLE RPH (PIC,AO)
(606) 633-4488
Entity
Organization
Contact information
Practice address
109 E MAIN ST, WHITESBURG, KY 41858-7351
(606) 633-4488
(606) 633-4849
Mailing address
109 E MAIN ST, WHITESBURG, KY 41858-7351
(606) 633-4488
(606) 633-4849
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
P06331
KY
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2030619
PK
—
05
—
7100204060
—
KY
Enumeration date
08/31/2006
Last updated
06/29/2016
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