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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