Organization
MIKELS DRIVE IN PHARMACY INC
Active
Organization
MIKELS DRIVE IN PHARMACY INC
Active
Other names
Fountain Square Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MAURICE MCGLONE (PHARMD)
(606) 248-1052
Entity
Organization
Contact information
Practice address
1928 CUMBERLAND AVE, MIDDLESBORO, KY 40965-1231
(606) 248-1052
(606) 248-6598
Mailing address
1928 CUMBERLAND AVE, MIDDLESBORO, KY 40965-1231
(606) 248-1052
(606) 248-6598
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
P07708
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2153658
PK
—
05
—
4582114
—
TN
05
—
54011945
—
KY
Enumeration date
07/19/2005
Last updated
06/28/2016
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up