Organization
SOUTHEASTERN FAMILY DRUG CENTER, INC
Active
Other names
Family Drug Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DANIEL K GRAY R.PH (PRESIDENT)
(606) 598-8831
Entity
Organization
Contact information
Practice address
110 MANCHESTER SHOPPING CTR, MANCHESTER, KY 40962-1401
(606) 598-8831
(606) 598-8838
Mailing address
110 MANCHESTER SHOPPING CTR, MANCHESTER, KY 40962-1401
(606) 598-8831
(606) 598-8838
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
PO1434
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
54017116
—
KY
05
—
90020264
—
KY
Enumeration date
01/08/2008
Last updated
01/08/2008
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