Organization
BON HARBOR RX, LLC
Active
Other names
Nation's Medicines
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID LARRY NATION (MEMBER/PHARMACIST)
(270) 864-5398
Entity
Organization
Contact information
Practice address
415 CARTER RD, OWENSBORO, KY 42301
(270) 685-0557
(270) 688-5858
Mailing address
3030 BURLEW BLVD, OWENSBORO, KY 42303-6486
(270) 684-5398
(270) 685-5742
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
PO1433
KY
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2030122
PK
—
05
—
54017090
—
KY
05
—
90330309
—
KY
Enumeration date
09/12/2006
Last updated
04/07/2021
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