Organization
COTTONGIM DRUG CO INC
Active
Other names
COTTONGIM DRUG COMPANY
Organization subpart
No
Provider details
NPI number
Authorized official
DONALD ROLLINS BS IN PHARMACY (SECRETARY PHARMACIST)
(606) 528-1304
Entity
Organization
Contact information
Practice address
300 S MAIN ST, CORBIN, KY 40701-1458
(606) 528-1304
(606) 528-1305
Mailing address
PO BOX 570, CORBIN, KY 40702-0570
(606) 528-1304
(606) 528-1305
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
P00234
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1804132
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
54007232
—
KY
05
—
90111188DME
—
KY
Enumeration date
10/19/2005
Last updated
06/20/2011
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