Organization
JBD INC
Active
Organization
JBD INC
Active
Other names
HEALTHY WAY PHARMACY CEDARKNOLL
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN DICKERSON RPH (PRES OWNER AO)
(606) 738-9790
Entity
Organization
Contact information
Practice address
1410 EAGLE DR, ASHLAND, KY 41102-9623
(606) 928-1001
(606) 928-1008
Mailing address
PO BOX 803, SANDY HOOK, KY 41171-0803
(606) 738-4041
(606) 738-4030
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
P07152
KY
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2034632
PK
—
05
—
54012729
—
KY
Enumeration date
12/06/2006
Last updated
08/11/2015
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