Provider Demographics
NPI:1013092576
Name:RX DISCOUNT PHARMACY INC
Entity Type:Organization
Organization Name:RX DISCOUNT PHARMACY INC
Other - Org Name:RX DISCOUNT PHARMACY #1
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:SLONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:606-436-2407
Mailing Address - Street 1:PO BOX 1569
Mailing Address - Street 2:
Mailing Address - City:HAZARD
Mailing Address - State:KY
Mailing Address - Zip Code:41702-1569
Mailing Address - Country:US
Mailing Address - Phone:606-436-2407
Mailing Address - Fax:606-436-0727
Practice Address - Street 1:500 MORTON BLVD
Practice Address - Street 2:
Practice Address - City:HAZARD
Practice Address - State:KY
Practice Address - Zip Code:41701-9473
Practice Address - Country:US
Practice Address - Phone:606-436-2891
Practice Address - Fax:606-436-0521
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-25
Last Update Date:2018-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 333600000X
KYP060913336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2031908OtherPK
KY54030085Medicaid
2031908OtherPK
KY90200973Medicaid