Provider Demographics
NPI:1356091078
Name:PHARMBOY INVESTMENTS LLC
Entity Type:Organization
Organization Name:PHARMBOY INVESTMENTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CPHT/PHARMACY MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:
Authorized Official - Last Name:MATTINGLY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-422-2422
Mailing Address - Street 1:1230 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:BRANDENBURG
Mailing Address - State:KY
Mailing Address - Zip Code:40108-1517
Mailing Address - Country:US
Mailing Address - Phone:270-422-2422
Mailing Address - Fax:270-422-3299
Practice Address - Street 1:1230 HIGH ST
Practice Address - Street 2:
Practice Address - City:BRANDENBURG
Practice Address - State:KY
Practice Address - Zip Code:40108-1517
Practice Address - Country:US
Practice Address - Phone:270-422-2422
Practice Address - Fax:270-422-3299
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-25
Last Update Date:2022-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy