Organization
BRANDENBURG CUSTOM MEDS LLC
Active
Organization
BRANDENBURG CUSTOM MEDS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DALE RAY GODBY R.PH. (OWNER)
(270) 422-2477
Entity
Organization
Contact information
Practice address
455 BYPASS RD STE C, BRANDENBURG, KY 40108-1745
(270) 422-2477
(270) 422-3299
Mailing address
455 BYPASS RD STE C, P.O. BOX 455, BRANDENBURG, KY 40108-1745
(270) 422-2477
(270) 422-3299
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
P06557
KY
Other
Enumeration date
05/18/2007
Last updated
08/22/2020
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