Organization
PDC, LLC
Active
Other names
Princeton Drug Store
Organization subpart
No
Provider details
NPI number
Authorized official
JIMMY L TUCKER RPH (OWNER, CEO, PRESIDENT)
(270) 365-5585
Entity
Organization
Contact information
Practice address
103 W MAIN ST, PRINCETON, KY 42445-1546
(270) 365-5585
(270) 365-0559
Mailing address
103 W MAIN ST, PRINCETON, KY 42445
(270) 365-5585
(270) 365-0559
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100544640
—
KY
Enumeration date
09/12/2006
Last updated
04/16/2023
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