Provider Demographics
NPI:1154402279
Name:PRESCRIPTION CENTER, INC.
Entity type:Organization
Organization Name:PRESCRIPTION CENTER, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SECRETARY, CO-OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:BEA
Authorized Official - Last Name:WILKERSON
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:270-526-3332
Mailing Address - Street 1:PO BOX 1640
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:42261-1640
Mailing Address - Country:US
Mailing Address - Phone:270-526-3332
Mailing Address - Fax:270-526-3996
Practice Address - Street 1:211 S. MAIN STREET
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:KY
Practice Address - Zip Code:42261-1640
Practice Address - Country:US
Practice Address - Phone:270-526-3332
Practice Address - Fax:270-526-3996
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-17
Last Update Date:2012-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYP06869-KY333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY54005392Medicaid
KY1807304OtherNCPDP
KY90006701OtherDURABLE MEDICAL
KY4880210001Medicare ID - Type Unspecified