Provider Demographics
NPI:1992681977
Name:WHITESBURG MEDICAL CENTER PHARMACY, INC.
Entity type:Organization
Organization Name:WHITESBURG MEDICAL CENTER PHARMACY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:EARNEST
Authorized Official - Middle Name:J
Authorized Official - Last Name:WATTS
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMACIST
Authorized Official - Phone:606-633-2222
Mailing Address - Street 1:2354 HWY 15
Mailing Address - Street 2:
Mailing Address - City:WHITESBURG
Mailing Address - State:KY
Mailing Address - Zip Code:41858
Mailing Address - Country:US
Mailing Address - Phone:606-633-2222
Mailing Address - Fax:606-633-4570
Practice Address - Street 1:9500 HWY 805
Practice Address - Street 2:
Practice Address - City:JENKINS
Practice Address - State:KY
Practice Address - Zip Code:41537
Practice Address - Country:US
Practice Address - Phone:606-832-6097
Practice Address - Fax:606-633-4570
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WHITESBURG MEDICAL CENTER PHARMACY, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-08-14
Last Update Date:2025-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy