Organization Name: | EASTRIDGE-PHELPS PHARMACY LLC |
NPI Number: | 1245478007 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | CHAD PHELPS (PHARMACIST/PIC/MEMBER) |
Mailing Address: | 101 Winston Way Suite A Campbellsville |
State: | KY US |
Postal Code: | 427184953 |
Phone Number: | 2707890577 |
Fax Number: | 2707890578 |
NPI Enumeration Date: | 01/31/2009 |
NPI Last Update Date: | 09/17/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332B00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | |
Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |