Fountain Square Pharmacy
LBN: Mikels Drive In Pharmacy Inc
Fountain Square Pharmacy is an health care organization with primary practice located at 1928 Cumberland Ave , Middlesboro KY 40965-1231. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty.
Mikels Drive In Pharmacy Inc can be contacted via phone (606) 248-1052, or through Mcglone, Maurice via phone (606) 248-1052.
Contact Information
Primary practice address
1928 Cumberland Ave
Middlesboro KY 40965-1231
Phone: (606) 248-1052
Fax: (606) 248-6598
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Pharmacy | 333600000X | ||
| Suppliers / Community/Retail Pharmacy | 3336C0003X | P07708 | Kentucky |
Profile Details
| NPI number | 1700885001 |
|---|---|
| LBN Legal business name | Mikels Drive In Pharmacy Inc |
| DBA Doing business as | Fountain Square Pharmacy |
| Authorized official | Mcglone, Maurice |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jul 19th, 2005 |
| Last updated | Jun 28th, 2016 - about 8 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1700885001 | NPPES |
| Other | 2153658 | PK | |
| MEDICAID | 54011945 | PK | |
| MEDICAID | 4582114 | PK |
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