Provider Demographics
NPI:1376949362
Name:PHARMACY CARE CENTER
Entity Type:Organization
Organization Name:PHARMACY CARE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST IN CHARGE
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:HURT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:606-435-0460
Mailing Address - Street 1:101 TOWN AND COUNTRY LN STE 101
Mailing Address - Street 2:
Mailing Address - City:HAZARD
Mailing Address - State:KY
Mailing Address - Zip Code:41701-9524
Mailing Address - Country:US
Mailing Address - Phone:606-435-0460
Mailing Address - Fax:606-435-0461
Practice Address - Street 1:101 TOWN AND COUNTRY LN STE 101
Practice Address - Street 2:
Practice Address - City:HAZARD
Practice Address - State:KY
Practice Address - Zip Code:41701-9524
Practice Address - Country:US
Practice Address - Phone:606-435-0460
Practice Address - Fax:606-435-0461
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-18
Last Update Date:2019-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYP076623336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy