Provider Demographics
NPI:1598790008
Name:DRIVE IN PHARMACY INC
Entity Type:Organization
Organization Name:DRIVE IN PHARMACY INC
Other - Org Name:DRIVE IN PHARMACY, INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMD, PIC,
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:RICKETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:606-549-0888
Mailing Address - Street 1:688 S HIGHWAY 25 W
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:KY
Mailing Address - Zip Code:40769-1697
Mailing Address - Country:US
Mailing Address - Phone:606-549-0888
Mailing Address - Fax:606-549-3217
Practice Address - Street 1:688 S HIGHWAY 25 W
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:KY
Practice Address - Zip Code:40769-1697
Practice Address - Country:US
Practice Address - Phone:606-549-0888
Practice Address - Fax:606-549-3217
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-12
Last Update Date:2010-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYP07019332B00000X, 3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
1815907OtherNCPDP PROVIDER IDENTIFICATION NUMBER
1815907OtherNCPDP PROVIDER IDENTIFICATION NUMBER