Provider Demographics
NPI:1326193236
Name:GLASGOW PRESCRIPTION CENTER, INC.
Entity Type:Organization
Organization Name:GLASGOW PRESCRIPTION CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:OLIVER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-651-8889
Mailing Address - Street 1:615 S L ROGER WELLS BLVD.
Mailing Address - Street 2:
Mailing Address - City:GLASGOW
Mailing Address - State:KY
Mailing Address - Zip Code:42141-2413
Mailing Address - Country:US
Mailing Address - Phone:270-651-8889
Mailing Address - Fax:270-651-8873
Practice Address - Street 1:615 S L ROGER WELLS BLVD.
Practice Address - Street 2:
Practice Address - City:GLASGOW
Practice Address - State:KY
Practice Address - Zip Code:42141-2413
Practice Address - Country:US
Practice Address - Phone:270-651-8889
Practice Address - Fax:270-651-8873
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-24
Last Update Date:2022-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYP00471183500000X, 3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100176830Medicaid