Organization
SRPB INC
Active
Other names
FLAGG SPRINGS PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL COLETTA (PRESIDENT)
(859) 394-2027
Entity
Organization
Contact information
Practice address
3501 SHORTCUT RD, CALIFORNIA, KY 41007-8471
(859) 448-0309
(859) 448-0312
Mailing address
3501 SHORTCUT RD, CALIFORNIA, KY 41007-8471
(859) 448-0309
(859) 448-0312
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
P07135
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1829728
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
10/10/2006
Last updated
06/13/2011
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