Organization
ADIO PHARMACY DISTRIBUTION SERVICES
Active
Other names
FOUR RIVERS PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
VICTOR SWAMI (OWNER)
(270) 538-0772
Entity
Organization
Contact information
Practice address
415 BROADWAY ST, PADUCAH, KY 42001-0713
(270) 538-0772
(270) 538-0773
Mailing address
415 BROADWAY ST, PADUCAH, KY 42001-0713
(270) 538-0772
(270) 538-0773
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
P06845
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2034082
PK
—
05
—
54004700
—
KY
Enumeration date
07/30/2006
Last updated
11/09/2015
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