Organization
PROFESSIONAL PHARMACY OF SOMERSET LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAM DAULTON (OWNER)
(606) 679-1169
Entity
Organization
Contact information
Practice address
342 BOGLE ST, SOMERSET, KY 42503-2851
(606) 679-1169
(606) 679-1049
Mailing address
342 BOGLE ST, SOMERSET, KY 42503-2851
(606) 679-1169
(606) 679-1049
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
7100039650
KY
3336C0003X
Community/Retail Pharmacy
P07206
KY
3336C0003X
Community/Retail Pharmacy
Primary
P07849
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2035126
PK
—
Enumeration date
09/20/2007
Last updated
04/02/2025
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