Organization
THREE STORES INC
Active
Other names
ANNVILLE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
HEATHER DANIELS (EXEXUTIVE ADMINISTRATOR)
(606) 436-2407
Entity
Organization
Contact information
Practice address
78 KY HIGHWAY 3444, SUITE 2, ANNVILLE, KY 40402-0095
(606) 364-3113
Mailing address
PO BOX 1569, HAZARD, KY 41702-1569
(606) 436-2407
(606) 436-0727
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
P07199
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2029545
PK
—
05
—
7100027890
—
KY
05
—
7100095790
—
KY
Enumeration date
10/23/2006
Last updated
06/18/2015
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