Organization
BOWYNN INC
Active
Other names
Wynn Express Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
SUE WYNN (PHARMACIST)
(606) 310-3105
Entity
Organization
Contact information
Practice address
43 MEDICAL LN, WHITLEY CITY, KY 42653-4216
(606) 376-1535
(606) 376-1537
Mailing address
PO BOX 1219, WHITLEY CITY, KY 42653
(606) 310-3105
(606) 376-1517
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
P07426
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2127768
PK
—
Enumeration date
12/01/2010
Last updated
03/30/2015
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