Organization
CLAY COMMUNITY PHARMACY LLC
Active
Other names
Clay Community Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT CRUSE (OWNER)
(606) 599-0209
Entity
Organization
Contact information
Practice address
118 CLAY CO S/C, MANCHESTER, KY 40962
(606) 599-0209
(606) 599-0279
Mailing address
118 CLAY CO S/C, MANCHESTER, KY 40962
(606) 599-0209
(606) 599-0279
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
P07577
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2140778
PK
—
Enumeration date
12/03/2012
Last updated
07/14/2015
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