Provider Demographics
NPI:1235975525
Name:SPENCER DRUG LLC
Entity type:Organization
Organization Name:SPENCER DRUG LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PIC
Authorized Official - Prefix:
Authorized Official - First Name:JANET
Authorized Official - Middle Name:WITT
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:606-723-5446
Mailing Address - Street 1:PO BOX 316
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:KY
Mailing Address - Zip Code:40336-0316
Mailing Address - Country:US
Mailing Address - Phone:606-723-5446
Mailing Address - Fax:606-723-9017
Practice Address - Street 1:1325 RICHMOND RD
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:KY
Practice Address - Zip Code:40336-7233
Practice Address - Country:US
Practice Address - Phone:606-723-5446
Practice Address - Fax:606-723-9017
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-05
Last Update Date:2024-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy