East Main Pharmacy Llc

LBN: East Main Street Pharmacy
East Main Pharmacy Llc is an health care organization with primary practice located at 279 E Main St , Hazard KY 41701-1920. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Community/Retail Pharmacy, Suppliers / Compounding Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. East Main Street Pharmacy can be contacted via phone (606) 487-0107, or through Wooton, Dachea via phone (606) 487-0107.

Contact Information

Primary practice address
279 E Main St Hazard KY 41701-1920
Phone: (606) 487-0107
Fax: (606) 487-0104
Website:
Map and Directions
Authorized official contact:
Name: Wooton, Dachea RPH
Phone: (606) 487-0107

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Community/Retail Pharmacy 3336C0003X P07502 Kentucky
Suppliers / Compounding Pharmacy 3336C0004X

Profile Details

NPI number 1174898746
LBN Legal business name East Main Street Pharmacy
DBA Doing business as East Main Pharmacy Llc
Authorized official Wooton, Dachea RPH
Entity Organization
Organization subpart 1 No
Enumeration date Mar 15th, 2012
Last updated Sep 17th, 2015 - about 10 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1174898746 NPPES
Kentucky MEDICAID 7100206580
Kentucky Other 2134045

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