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Organization

ISOM COMMUNITY PHARMACY INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SCOTT E. BURRIS RPH (PHARMACIST)
(606) 633-9238
Entity
Organization

Contact information

Practice address
93 ISOM PLAZA, ISOM, KY 41824-9011
(606) 633-9238
Mailing address
PO BOX 250, 93 ISOM PLAZA, ISOM, KY 41824-0250
(606) 633-9238

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
P06559
KY
3336C0003X
Community/Retail Pharmacy
Primary
P06559
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
54000864
KY
05
90001546
KY
Enumeration date
05/26/2006
Last updated
10/05/2012
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