Provider Demographics
NPI:1245234798
Name:ELDRON, INC
Entity Type:Organization
Organization Name:ELDRON, INC
Other - Org Name:GOODY ECONOMY DRUG
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EVELYN
Authorized Official - Middle Name:
Authorized Official - Last Name:BILLITER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:606-237-7220
Mailing Address - Street 1:28019 US HIGHWAY 119
Mailing Address - Street 2:
Mailing Address - City:SOUTH WILLIAMSON
Mailing Address - State:KY
Mailing Address - Zip Code:41503-3915
Mailing Address - Country:US
Mailing Address - Phone:606-237-7220
Mailing Address - Fax:606-237-4873
Practice Address - Street 1:28019 US HIGHWAY 119
Practice Address - Street 2:
Practice Address - City:SOUTH WILLIAMSON
Practice Address - State:KY
Practice Address - Zip Code:41503-3915
Practice Address - Country:US
Practice Address - Phone:606-237-7220
Practice Address - Fax:606-237-4873
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYP01891183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY54020615Medicaid
KY54020615Medicaid