Organization
RIVER DRIVE PHARMACY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VIVIAN ONG (MEMBER)
(606) 723-0265
Entity
Organization
Contact information
Practice address
223 RIVER DR, IRVINE, KY 40336-1142
(606) 723-0265
Mailing address
223 RIVER DR, IRVINE, KY 40336-1142
(606) 723-0265
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
P07394
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100127260
—
KY
Enumeration date
05/04/2010
Last updated
09/12/2018
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