Provider Demographics
NPI:1366484826
Name:WIGGINS DRUGS LIMITED
Entity Type:Organization
Organization Name:WIGGINS DRUGS LIMITED
Other - Org Name:KING DRUG & HOME CARE - HARTFORD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING PARTNER/OWNER/ADMINISTRATO
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:WIGGINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-298-0259
Mailing Address - Street 1:PO BOX 145
Mailing Address - Street 2:
Mailing Address - City:HARTFORD
Mailing Address - State:KY
Mailing Address - Zip Code:42347-0145
Mailing Address - Country:US
Mailing Address - Phone:270-298-0259
Mailing Address - Fax:270-298-7641
Practice Address - Street 1:1014 S MAIN ST
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:KY
Practice Address - Zip Code:42347-1830
Practice Address - Country:US
Practice Address - Phone:270-298-3278
Practice Address - Fax:270-298-3290
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-11
Last Update Date:2016-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYPO7045332B00000X, 3336C0003X
KYHME00228332B00000X, 332B00000X
KYP07045333600000X
KYPO70813336H0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY1805095OtherNCPDP
KY54010707OtherMEDICAID-PHARMACY
KY90013517OtherMEDICAID-DME
KY54010707OtherMEDICAID-PHARMACY