Provider Demographics
NPI:1447505268
Name:EAST KENTUCKY DRUG INC.
Entity type:Organization
Organization Name:EAST KENTUCKY DRUG INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:MRS
Authorized Official - First Name:CELINA
Authorized Official - Middle Name:E
Authorized Official - Last Name:HOWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:606-478-3784
Mailing Address - Street 1:PO BOX 340
Mailing Address - Street 2:
Mailing Address - City:VIRGIE
Mailing Address - State:KY
Mailing Address - Zip Code:41572-0340
Mailing Address - Country:US
Mailing Address - Phone:606-639-2415
Mailing Address - Fax:606-478-3788
Practice Address - Street 1:160 CONN ST.
Practice Address - Street 2:SUITE 2
Practice Address - City:IVEL
Practice Address - State:KY
Practice Address - Zip Code:41642
Practice Address - Country:US
Practice Address - Phone:606-478-3784
Practice Address - Fax:606-478-3788
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-18
Last Update Date:2015-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYPO75123336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy