Provider Demographics
NPI:1457118044
Name:MEDICAL ARTS PHARMACY OF GLASGOW, INC.
Entity Type:Organization
Organization Name:MEDICAL ARTS PHARMACY OF GLASGOW, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:DR
Authorized Official - First Name:TREVOR
Authorized Official - Middle Name:VANCE
Authorized Official - Last Name:RAY
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:270-259-8500
Mailing Address - Street 1:1220 N RACE ST
Mailing Address - Street 2:
Mailing Address - City:GLASGOW
Mailing Address - State:KY
Mailing Address - Zip Code:42141-3462
Mailing Address - Country:US
Mailing Address - Phone:270-651-7030
Mailing Address - Fax:270-651-9948
Practice Address - Street 1:1220 N RACE ST
Practice Address - Street 2:
Practice Address - City:GLASGOW
Practice Address - State:KY
Practice Address - Zip Code:42141-3462
Practice Address - Country:US
Practice Address - Phone:270-651-7030
Practice Address - Fax:270-651-9948
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-29
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy