Organization
MEDICAL CENTER PHARMACY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZABETH A GENTRY PHARM (SECRETARY)
(270) 684-3414
Entity
Organization
Contact information
Practice address
1010 MEDICAL CENTER DR, POWDERLY, KY 42367-5463
(270) 338-9993
(270) 338-9903
Mailing address
1010 MEDICAL CENTER DR, POWDERLY, KY 42367-5463
(270) 338-9993
(270) 338-9903
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100200080
—
KY
01
—
P06622
STATE LICENSE NUMBER
KY
Enumeration date
12/04/2006
Last updated
03/07/2023
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