Organization
DRIVE IN PHARMACY INCORPORATED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICHARD L. L HARRIS SR. (OWNER)
(606) 549-0812
Entity
Organization
Contact information
Practice address
688 S HIGHWAY 25 W, WILLIAMSBURG, KY 40769-1697
(606) 549-0888
(606) 549-3217
Mailing address
PO BOX 460, WILLIAMSBURG, KY 40769-0460
(606) 549-0888
(606) 549-3217
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
MG0497
KY
333600000X
Pharmacy
P07019
KY
3336C0003X
Community/Retail Pharmacy
Primary
P07019
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1832307
NCPDP PROVIDER IDENTIFICATION NUMBER
—
01
—
6481650001
PTAN MEDICARE DME SUPPLIER NSC
KY
05
—
7100157900
—
KY
Enumeration date
02/25/2011
Last updated
05/14/2012
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