Provider Demographics
NPI:1891793261
Name:GLASGOW PRESCRIPTION CENTER, INC.
Entity Type:Organization
Organization Name:GLASGOW PRESCRIPTION CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:OLIVER
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:270-651-8889
Mailing Address - Street 1:615 S L ROGERS WELLS BLVD
Mailing Address - Street 2:
Mailing Address - City:GLASGOW
Mailing Address - State:KY
Mailing Address - Zip Code:42141-1074
Mailing Address - Country:US
Mailing Address - Phone:270-651-8889
Mailing Address - Fax:270-651-6198
Practice Address - Street 1:615 S L ROGERS WELLS BLVD
Practice Address - Street 2:
Practice Address - City:GLASGOW
Practice Address - State:KY
Practice Address - Zip Code:42141-1074
Practice Address - Country:US
Practice Address - Phone:270-651-8889
Practice Address - Fax:270-651-6198
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-11
Last Update Date:2015-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYP00471332B00000X, 332BP3500X, 3336C0003X
KYMG0696332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000069992OtherDME
KY90010059Medicaid
KY0409580001Medicare NSC