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Organization

MOUNTAIN APOTHECARY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
TONYA WESTMORELAND BS (PRESIDENT)
(606) 789-6150
Entity
Organization

Contact information

Practice address
834 S MAYO TRL, PAINTSVILLE, KY 41240-1384
(606) 789-6150
(606) 789-6156
Mailing address
834 S MAYO TRL, PAINTSVILLE, KY 41240-1384
(606) 789-6150
(606) 789-6156

Taxonomy

Speciality
Code
Description
License number
State
333600000X
Pharmacy
3336C0003X
Community/Retail Pharmacy
Primary
P02544
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2031854
PK
05
54029152
KY
Enumeration date
08/10/2006
Last updated
02/15/2017
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