Organization
BLACK GOLD PHARMACY LLC
Active
Other names
Black Gold Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
HOWARD ROBINSON (PHARMACIST/PIC)
(606) 436-0045
Entity
Organization
Contact information
Practice address
173 CITIZENS LANE, HAZARD, KY 41701
(606) 436-0045
Mailing address
173 CITIZENS LANE, HAZARD, KY 41701
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
P07333
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1831165
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
04/13/2009
Last updated
04/29/2009
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