Organization
PEYTON'S PHARMACY, INC
Active
Organization
PEYTON'S PHARMACY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEVEN WAYNE ROY RPH (OWNER)
(606) 743-3163
Entity
Organization
Contact information
Practice address
414 MAIN ST, WEST LIBERTY, KY 41472-1014
(606) 743-3163
(606) 743-3335
Mailing address
414 MAIN ST, WEST LIBERTY, KY 41472-1014
(606) 743-3163
(606) 743-3335
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
9000556200
KY
3336C0003X
Community/Retail Pharmacy
Primary
P00752
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
54012026
—
KY
01
—
9000556200
KY MEDICAID DME
KY
Enumeration date
11/25/2006
Last updated
05/13/2008
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