Organization
PDC, LLC
Active
Other names
Princeton Drug Store
Organization subpart
No
Provider details
NPI number
Authorized official
JIMMY L TUCKER RPH (OWNER, PRESIDENT, CEO)
(270) 365-5585
Entity
Organization
Contact information
Practice address
103 W MAIN ST, PRINCETON, KY 42445-1546
(270) 365-5585
Mailing address
103 W MAIN ST, PRINCETON, KY 42445-1546
(270) 365-5585
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
P07858
KY
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100164190
—
KY
Enumeration date
04/20/2016
Last updated
04/16/2023
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