Organization
BRANDENBURG PHARMACY CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DALE GODBY RPH (OWNER)
(270) 422-2422
Entity
Organization
Contact information
Practice address
455 BYPASS RD STE D, BRANDENBURG, KY 40108-1745
(270) 422-2422
(270) 422-3299
Mailing address
PO BOX 455, BRANDENBURG, KY 40108-0455
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
P06556
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1826342
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
54000799
—
KY
Enumeration date
06/08/2006
Last updated
10/18/2007
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