Organization
DAVID R. WHITLEY
Active
Other names
Whitley's Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID RANDALL WHITLEY (OWNER , R.PH.)
(270) 726-9592
Entity
Organization
Contact information
Practice address
501 N MAIN ST, RUSSELLVILLE, KY 42276-1636
(270) 726-9592
(270) 726-9881
Mailing address
501 N MAIN ST, RUSSELLVILLE, KY 42276-1636
(270) 726-9592
(270) 726-9881
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
P01622
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1815072
NCPDP NUMBER
—
05
—
54018767
—
KY
Enumeration date
02/13/2007
Last updated
05/22/2013
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