Organization
ROCKCASTLE VENTURES INC.
Active
Other names
Rockcastle Professional Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
BRANDY BULLOCK (DIRECTOR)
(606) 256-7761
Entity
Organization
Contact information
Practice address
110 NEWCOMB AVENUE, MT. VERNON, KY 40456
(606) 256-4613
Mailing address
PO BOX 1860, MOUNT VERNON, KY 40456-1860
(606) 256-4613
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
P07179
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100002320
—
KY
01
—
7100027800
MEDICAID DME
—
01
—
P07179
KY PHARMACY LICENSE
KY
Enumeration date
03/28/2007
Last updated
03/07/2023
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