Provider Demographics
NPI:1922307057
Name:TOWN AND COUNTRY PHARMACY
Entity Type:Organization
Organization Name:TOWN AND COUNTRY PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:WANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:NOLEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:606-316-2031
Mailing Address - Street 1:491 W 2ND ST
Mailing Address - Street 2:
Mailing Address - City:MAYSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:41056-1008
Mailing Address - Country:US
Mailing Address - Phone:606-481-4209
Mailing Address - Fax:859-966-2589
Practice Address - Street 1:657 MAIN STREET
Practice Address - Street 2:
Practice Address - City:SHARPSBURG
Practice Address - State:KY
Practice Address - Zip Code:40374
Practice Address - Country:US
Practice Address - Phone:606-481-4209
Practice Address - Fax:859-966-2589
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-15
Last Update Date:2011-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy