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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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