Organization
SPECIALTY MEDICAL DRUGSTORE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RONALD FERGUSON (PRESIDENT)
(888) 795-5826
Entity
Organization
Contact information
Practice address
525 ALEXANDRIA PIKE, SOUTHGATE, KY 41071-3290
(888) 795-5826
Mailing address
525 ALEXANDRIA PIKE, SOUTHGATE, KY 41071-3290
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
P07653
KY
Other
Enumeration date
12/17/2014
Last updated
12/17/2014
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