Organization
COLLEGE SQUARE PHARMACY
Active
Parent organization
COLLEGE SQUARE PHARMACY
Other names
Knights Pharmacy
Organization subpart
Yes
Provider details
NPI number
Legal business name
COLLEGE SQUARE PHARMACY
Authorized official
MRS. ERIN E KNIGHT (OWNER)
(859) 986-0500
Entity
Organization
Contact information
Practice address
191 GLADES RD, BEREA, KY 40403
(859) 986-0500
(859) 986-0505
Mailing address
PO BOX 1018, BEREA, KY 40403
(859) 986-0500
(859) 986-0505
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
P06904
KY
333600000X
Pharmacy
P06904
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
54006085
—
KY
05
—
90008384
—
KY
01
—
P300037221
PTAN
KY
Enumeration date
09/15/2005
Last updated
03/22/2011
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