Organization
ELYDRUGS OF BG INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LINDSEY PEDEN R.PH. (MANAGER)
(270) 467-5225
Entity
Organization
Contact information
Practice address
4863 SCOTTSVILLE RD, BOWLING GREEN, KY 42104-7909
(270) 467-5225
Mailing address
4863 SCOTTSVILLE RD, BOWLING GREEN, KY 42104-7909
(270) 467-5225
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
P07503
KY
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
P07503
KY
332BX2000X
Oxygen Equipment & Supplies (DME)
P07503
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
710002368
—
KY
Enumeration date
12/23/2013
Last updated
12/23/2013
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