Organization
RUSSELL SPRINGS PHARMACY
Active
Organization
RUSSELL SPRINGS PHARMACY
Active
Other names
Russell Springs Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JEFF WARNER (PHARMACIST PARTNER)
(270) 866-2778
Entity
Organization
Contact information
Practice address
92 JOE T PETTY DR, STE 100, RUSSELL SPRINGS, KY 42642-8544
(270) 866-2778
(270) 866-2779
Mailing address
92 JOE T PETTY DR, STE 100, RUSSELL SPRINGS, KY 42642-8544
(270) 866-2778
(270) 866-2779
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
P07329
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1829881
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
7100070700
—
KY
Enumeration date
01/08/2007
Last updated
08/23/2011
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