Organization
SAM'S PROFESSIONAL PHARMACY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SAMUEL MOORE PHARMD, RPH (PRESIDENT)
(606) 546-3317
Entity
Organization
Contact information
Practice address
2 KNOX PLZ, BARBOURVILLE, KY 40906-7300
(606) 546-3317
(606) 546-3928
Mailing address
PO BOX 1766, BARBOURVILLE, KY 40906-5766
(606) 546-3317
(606) 546-3928
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
P06975
KY
333600000X
Pharmacy
Primary
P06975
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5400829700
—
KY
Enumeration date
11/16/2006
Last updated
03/31/2008
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