Provider Demographics
NPI:1528045960
Name:RX DISCOUNT PHARMACY OF HARLAN INC
Entity Type:Organization
Organization Name:RX DISCOUNT PHARMACY OF HARLAN INC
Other - Org Name:RX DISCOUNT PHARMACY #7
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:K
Authorized Official - Last Name:SLONE
Authorized Official - Suffix:SR
Authorized Official - Credentials:RPH
Authorized Official - Phone:606-436-2891
Mailing Address - Street 1:1841 N 25TH ST
Mailing Address - Street 2:
Mailing Address - City:MIDDLESBORO
Mailing Address - State:KY
Mailing Address - Zip Code:40965-1853
Mailing Address - Country:US
Mailing Address - Phone:606-248-9330
Mailing Address - Fax:606-248-9337
Practice Address - Street 1:1841 N 25TH ST
Practice Address - Street 2:
Practice Address - City:MIDDLESBORO
Practice Address - State:KY
Practice Address - Zip Code:40965-1853
Practice Address - Country:US
Practice Address - Phone:606-248-9330
Practice Address - Fax:606-248-9337
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY54005434Medicaid
KY1161460002Medicare ID - Type Unspecified