Organization
APOTHECARY SHOPPE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. P DAVE WRIGHT (CFO)
(270) 247-3111
Entity
Organization
Contact information
Practice address
1520 CUBA RD, MAYFIELD, KY 42066-6809
(270) 247-3111
(270) 247-2005
Mailing address
1520 CUBA RD, MAYFIELD, KY 42066-6809
(270) 247-3111
(270) 247-2005
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
P06775
KY
3336C0003X
Community/Retail Pharmacy
Primary
P06775
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1827483
NCPDP PROVIDER NUMBER
KY
05
—
54003520
—
KY
05
—
90006784
—
KY
Enumeration date
08/14/2006
Last updated
08/28/2010
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