Organization
COOLEY APOTHECARY INC
Active
Organization
COOLEY APOTHECARY INC
Active
Other names
COOLEY APOTHECARY INC
Organization subpart
No
Provider details
NPI number
Authorized official
WANDA K SALYER (OWNER/VICE PRESIDENT)
(606) 886-8106
Entity
Organization
Contact information
Practice address
128 N LAKE DR, PRESTONSBURG, KY 41653-1270
(606) 886-8106
(606) 886-8148
Mailing address
PO BOX 166, PRESTONSBURG, KY 41653-0166
(606) 886-8106
(606) 886-8148
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
P01044
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1808039
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
54012547
—
KY
Enumeration date
10/05/2005
Last updated
09/19/2012
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