Provider Demographics
NPI:1992139232
Name:PRESCRIPTION SHOPPE INC.
Entity type:Organization
Organization Name:PRESCRIPTION SHOPPE INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:STEPHENS
Authorized Official - Suffix:SR
Authorized Official - Credentials:RPH
Authorized Official - Phone:270-634-0530
Mailing Address - Street 1:101 INDUSTRIAL PARK RD STE 1
Mailing Address - Street 2:
Mailing Address - City:GREENSBURG
Mailing Address - State:KY
Mailing Address - Zip Code:42743-1383
Mailing Address - Country:US
Mailing Address - Phone:270-634-0530
Mailing Address - Fax:
Practice Address - Street 1:101 INDUSTRIAL PARK RD STE 1
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:KY
Practice Address - Zip Code:42743-1383
Practice Address - Country:US
Practice Address - Phone:270-634-0530
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-22
Last Update Date:2013-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy