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
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