Organization
EASTSIDE PHARMACY OF CYNTHIANA, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NANCY JUDY WALKER RPH (PHARMACIST-IN-CHARGE)
(859) 234-6800
Entity
Organization
Contact information
Practice address
430 E PLEASANT ST STE 2, CYNTHIANA, KY 41031-1614
(859) 234-6800
Mailing address
430 E PLEASANT ST STE 2, CYNTHIANA, KY 41031-1614
(859) 234-6800
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
P00966
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1809106
NCPDP
KY
05
—
54013339
—
KY
Enumeration date
11/11/2006
Last updated
08/22/2020
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