Organization
SALEM CLINIC PHARMACY INC
Active
Other names
CLINIC PHARMACY OF KY
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL KELLER RPH (OWNER,PIC,AO)
(270) 988-3230
Entity
Organization
Contact information
Practice address
141 HOSPITAL DR, SALEM, KY 42078-8043
(270) 988-3230
(270) 988-4230
Mailing address
PO BOX 498, SALEM, KY 42078-0498
(270) 988-3230
(270) 988-4230
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
P06918
KY
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2029123
PK
—
05
—
4554139800
—
KY
05
—
54017165
—
KY
05
—
7100171870
—
KY
05
—
9001070300
—
KY
Enumeration date
10/02/2006
Last updated
09/04/2015
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