Organization
CLAY CITY PHARMACY THOMAS H RIDENOUR
Active
Other names
CLAY CITY PHARMACY, INC.
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS RIDENOUR (OWNER)
(812) 939-2173
Entity
Organization
Contact information
Practice address
730 MAIN ST, CLAY CITY, IN 47841-1332
(812) 939-2173
(812) 939-2508
Mailing address
730 MAIN ST, CLAY CITY, IN 47841-1332
(812) 939-2173
(812) 939-2508
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
60002785A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100081340
—
IN
01
—
2023798
PK
—
Enumeration date
02/06/2007
Last updated
12/16/2014
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