Organization
MEDICORP, INC
Active
Other names
Parkway Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EARNEST J. WATTS R.PH. (PRESIDENT/ PHARMACIST)
(606) 633-4435
Entity
Organization
Contact information
Practice address
2354 HIGHWAY 15, WHITESBURG, KY 41858-7413
(606) 633-4435
(606) 633-4570
Mailing address
2354 HIGHWAY 15, WHITESBURG, KY 41858-7413
(606) 633-4435
(606) 633-4570
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
PO1472
KY
3336C0003X
Community/Retail Pharmacy
Primary
P01472
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1814195
NCDPD
KY
05
—
54017371
—
KY
05
—
90080672
—
KY
Enumeration date
06/17/2006
Last updated
04/20/2008
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