Provider Demographics
NPI:1265603039
Name:PILLER, INC.
Entity type:Organization
Organization Name:PILLER, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER, PRESIDENT, PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:VERLON
Authorized Official - Middle Name:L
Authorized Official - Last Name:PIERCE
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:270-843-3202
Mailing Address - Street 1:818 US 3LW BYP
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:KY
Mailing Address - Zip Code:42101
Mailing Address - Country:US
Mailing Address - Phone:270-843-3202
Mailing Address - Fax:270-782-8181
Practice Address - Street 1:818 US 3LW BYPASS
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:KY
Practice Address - Zip Code:42101-2314
Practice Address - Country:US
Practice Address - Phone:270-843-3202
Practice Address - Fax:270-782-8181
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-19
Last Update Date:2008-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYP01259332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY90231143Medicaid