Provider Demographics
NPI:1992425391
Name:ELY DRUGS INC
Entity type:Organization
Organization Name:ELY DRUGS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:JESSEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-467-5220
Mailing Address - Street 1:PO BOX 1778
Mailing Address - Street 2:
Mailing Address - City:GLASGOW
Mailing Address - State:KY
Mailing Address - Zip Code:42142-1778
Mailing Address - Country:US
Mailing Address - Phone:270-651-5159
Mailing Address - Fax:
Practice Address - Street 1:415 HAPPY VALLEY RD
Practice Address - Street 2:
Practice Address - City:GLASGOW
Practice Address - State:KY
Practice Address - Zip Code:42141-1537
Practice Address - Country:US
Practice Address - Phone:270-651-5159
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-29
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy