Organization
MOUNTAIN CLINIC PHARMACY LLC
Active
Organization
MOUNTAIN CLINIC PHARMACY LLC
Active
Other names
MOUNTAIN CLINIC PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
BROOKS WEBB RPH (PARTNER)
(606) 438-2445
Entity
Organization
Contact information
Practice address
233 E MAIN ST, SUITE B, HAZARD, KY 41701-1954
(606) 436-0045
(606) 436-0048
Mailing address
233 E MAIN ST, SUITE B, HAZARD, KY 41701-1954
(606) 436-0045
(606) 436-0048
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
P07143
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1829742
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
54012190
—
KY
Enumeration date
10/13/2006
Last updated
09/15/2011
Update your record
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