Provider Demographics
NPI:1891836524
Name:WIGGINS DRUGS LIMITED
Entity Type:Organization
Organization Name:WIGGINS DRUGS LIMITED
Other - Org Name:KING DRUG AND HOME CARE MORGANTOWN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING PARTNER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:T
Authorized Official - Last Name:WIGGINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-298-0259
Mailing Address - Street 1:PO BOX 145
Mailing Address - Street 2:
Mailing Address - City:HARTFORD
Mailing Address - State:KY
Mailing Address - Zip Code:42347-0145
Mailing Address - Country:US
Mailing Address - Phone:270-298-0259
Mailing Address - Fax:270-298-7641
Practice Address - Street 1:255 W GL SMITH ST
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:KY
Practice Address - Zip Code:42261
Practice Address - Country:US
Practice Address - Phone:270-526-6980
Practice Address - Fax:270-526-6981
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-08
Last Update Date:2016-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYHME00234332B00000X
KYP07225333600000X
KYPO72253336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY90013467OtherMEDICAID - DME
KY1829944OtherNCPDP
KY7100016010OtherMEDICAID - PHARMACY
KY7100016010OtherMEDICAID - PHARMACY