Organization
PRESCRIPTION SHOPPE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICHARD EUGENE DAVIS (ACCOUNTANT)
(270) 384-2132
Entity
Organization
Contact information
Practice address
808 JAMESTOWN ST, COLUMBIA, KY 42728-1010
(270) 384-2132
(270) 384-4541
Mailing address
808 JAMESTOWN ST, COLUMBIA, KY 42728-1010
(270) 384-2132
(270) 384-4541
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
90030016
—
KY
Enumeration date
08/18/2005
Last updated
08/22/2020
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