Organization
BURGESS DRUG STORE INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAIME P. BALL PHARMD (DR./OWNER)
(606) 310-3910
Entity
Organization
Contact information
Practice address
1 S. CREEK DR., STE. #122, MONTICELLO, KY 42633
(606) 376-5043
(606) 376-5466
Mailing address
PO BOX 279, WHITLEY CITY, KY 42653
(606) 376-5043
(606) 376-5466
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
—
—
3336C0003X
Community/Retail Pharmacy
—
—
Other
Enumeration date
12/02/2019
Last updated
12/02/2019
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