Provider Demographics
NPI: | 1437333127 |
---|---|
Name: | MC T'S INC. |
Entity Type: | Organization |
Organization Name: | MC T'S INC. |
Other - Org Name: | PAUL'S CORNER PHARMACY |
Other - Org Type: | Doing Business As |
Authorized Official - Title/Position: | PRESIDENT |
Authorized Official - Prefix: | MR |
Authorized Official - First Name: | PAUL |
Authorized Official - Middle Name: | B |
Authorized Official - Last Name: | MCCREARY |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | RPH |
Authorized Official - Phone: | 859-219-0594 |
Mailing Address - Street 1: | 121 W VIRGINIA AVE |
Mailing Address - Street 2: | STE E100 |
Mailing Address - City: | PINEVILLE |
Mailing Address - State: | KY |
Mailing Address - Zip Code: | 40977-1661 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 606-337-5500 |
Mailing Address - Fax: | 606-337-5001 |
Practice Address - Street 1: | 121 W VIRGINIA AVE |
Practice Address - Street 2: | STE E100 |
Practice Address - City: | PINEVILLE |
Practice Address - State: | KY |
Practice Address - Zip Code: | 40977-1661 |
Practice Address - Country: | US |
Practice Address - Phone: | 606-337-5500 |
Practice Address - Fax: | 606-337-5001 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2007-12-18 |
Last Update Date: | 2007-12-18 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
KY | PO7223 | 3336C0002X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 3336C0002X | Suppliers | Pharmacy | Clinic Pharmacy |