Organization
HINES PHARMACY AT WKOA LLC
Active
Organization
HINES PHARMACY AT WKOA LLC
Active
Other names
HINES PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
GREG HINES BS (PRESIDENT)
(270) 796-1818
Entity
Organization
Contact information
Practice address
165 NATCHEZ TRACE AVE, STE 101, BOWLING GREEN, KY 42103
(270) 796-1818
(270) 796-1988
Mailing address
165 NATCHEZ TRACE AVE, STE 101, BOWLING GREEN, KY 42103-7940
(270) 796-1818
(270) 796-1988
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
P07245
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2035125
PK
—
05
—
7100037420
—
KY
Enumeration date
03/24/2008
Last updated
06/28/2018
Update your record
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