Organization
MT. VERNON DRUG, INC.
Active
Other names
Stanford Drug
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALLISON STIGALL GRUBBS PHARM.D. (PHARMACIST IN CHARGE)
(606) 365-2100
Entity
Organization
Contact information
Practice address
107 METKER TRL STE D, STANFORD, KY 40484-1049
(606) 365-2100
(606) 365-4153
Mailing address
PO BOX 364, STANFORD, KY 40484-0364
(606) 365-2100
(606) 365-4153
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
P06743
KY
3336C0003X
Community/Retail Pharmacy
Primary
P06743
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
54003157
—
KY
05
—
90006503
—
KY
Enumeration date
09/16/2006
Last updated
03/07/2023
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