Ephraim McDowell Liberty Pharmacy

Organization Active NPI Community/Retail Pharmacy · Liberty, KY

NPI 1396852307 · NPPES record last updated Apr 17, 2012

Key facts

NPI
1396852307
Entity type
Organization (NPI type 2)
Primary specialty
Community/Retail Pharmacy 3336C0003X
License
P07029 (KY)
Legal business name
EPHRAIM MCDOWELL LIBERTY PHARMACY
Practice address
68 Hustonville Street
Liberty, KY 42539-3456
Phone
(859) 239-1721
NPI assigned
Aug 24, 2006
Organization subpart
No

Authorized official

Name
Dr. Joan B Haltom, PHARMD
Title
Director of Pharmacy Services
Phone
(859) 239-1721

Corporate family (same tax ID) 13

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
Ephraim McDowell Reg Me (14 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Community/Retail Pharmacy 3336C0003X P07029 KY Yes

Addresses

Primary practice location

68 Hustonville Street
Liberty, KY 42539-3456

Mailing address

217 South Third Street
Dept of Pharmacy
Danville, KY 40422-8911
Phone (859) 239-1721

Other identifiers

IdentifierTypeStateIssuer
54011507MedicaidKY

Other names

  • Wellness First Pharmacy Former legal business name

Other providers in Liberty, KY

All providers in Liberty, KY · Community/Retail Pharmacy in Kentucky

Sources for this page

Verify at the official NPI Registry.