Organization
COAL GROVE PHARMACY INC
Active
Other names
COAL GROVE PHARMACY INC
Organization subpart
No
Provider details
NPI number
Authorized official
JASON PLUMMER RPH (OWNER, PIC)
(740) 533-2479
Entity
Organization
Contact information
Practice address
600 MARION PIKE, IRONTON, OH 45638-2963
(740) 533-2479
(740) 533-2481
Mailing address
600 MARION PIKE, IRONTON, OH 45638-2963
(740) 533-2479
(740) 533-2481
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
021427050
OH
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2080349
PK
—
05
—
2615343
—
OH
05
—
54011481
—
KY
Enumeration date
06/18/2006
Last updated
03/14/2016
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