Provider Demographics
NPI:1871133116
Name:TOMPKINSVILLE DRUGS LLC
Entity type:Organization
Organization Name:TOMPKINSVILLE DRUGS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PIC
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:P
Authorized Official - Last Name:NIXON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-487-6155
Mailing Address - Street 1:1513 EDMONTON RD
Mailing Address - Street 2:
Mailing Address - City:TOMPKINSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42167-9402
Mailing Address - Country:US
Mailing Address - Phone:270-487-6155
Mailing Address - Fax:270-487-6157
Practice Address - Street 1:1513 EDMONTON RD
Practice Address - Street 2:
Practice Address - City:TOMPKINSVILLE
Practice Address - State:KY
Practice Address - Zip Code:42167-9402
Practice Address - Country:US
Practice Address - Phone:270-487-6155
Practice Address - Fax:270-487-6157
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-15
Last Update Date:2020-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy