Organization
MIKE'S PHARMACY, LLC
Active
Other names
Mike's Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL WAYNE SEIBER R.PH (OWNER/PHARMACIST)
(270) 871-3530
Entity
Organization
Contact information
Practice address
104 S. LEE TROVER TODD JR HWY, EARLINGTON, KY 42410
(270) 905-4046
(270) 905-4047
Mailing address
104 S. LEE TROVER TODD JR HWY, EARLINGTON, KY 42410
(270) 905-4046
(270) 905-4047
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
P07602
KY
3336C0004X
Compounding Pharmacy
—
—
3336M0002X
Mail Order Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2143183
PK
—
05
—
7100275060
—
KY
Enumeration date
12/06/2013
Last updated
09/05/2018
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