Organization
SOUTH DIXIE PHARMACY LLC
Active
Organization
SOUTH DIXIE PHARMACY LLC
Active
Other names
South Dixie Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MATTHEW W DANIELS PHARMD (CO-OWNER/PHARMACIST)
(270) 949-3494
Entity
Organization
Contact information
Practice address
12134 SOUTH DIXIE HIGHWAY, SONORA, KY 42776
(270) 949-3494
(270) 949-3494
Mailing address
12134 SOUTH DIXIE HIGHWAY, SONORA, KY 42776
(270) 949-3494
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
P07531
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100217350
—
KY
Enumeration date
08/27/2012
Last updated
11/12/2021
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