Organization
PRESTONSBURG PHARMACIST GROUP LLC
Active
Parent organization
PRESTONSBURG PHARMACIST GROUP LLC
Other names
ARCHER CLINIC PHARMACY
Organization subpart
Yes
Provider details
NPI number
Legal business name
PRESTONSBURG PHARMACIST GROUP LLC
Authorized official
JUSTIN BELL (PRESIDENT)
(502) 370-4336
Entity
Organization
Contact information
Practice address
400 UNIVERSITY DR, SUITE 100, PRESTONSBURG, KY 41653
(606) 886-1202
(606) 886-1346
Mailing address
1002 SOUTH BROADWAY, SUITE 7, GEORGETOWN, KY 40324
(502) 370-4336
(502) 370-4352
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
P01662
KY
3336C0004X
Compounding Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2030532
PK
—
05
—
54019179
—
KY
Enumeration date
07/30/2006
Last updated
09/19/2018
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