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Contact Information

MIDWAY PHARMACY OF CLARKSON INC
9847 ELIZABETHTOWN RD
STE 102
BIG CLIFTY, KY42712-5880
 Phone: 270-242-4344
 Fax: 844-607-4506
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community/Retail Pharmacy

3336C0003X 58 Medical Supply Company with Pharmacist
 

Compounding Pharmacy

3336C0004X 58 Medical Supply Company with Pharmacist
 

Durable Medical Equipment & Medical Supplies

332B00000X 54 Other Medical Supply Company
 

Pharmacy

333600000X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for MIDWAY PHARMACY OF CLARKSON INC

NPI # 1912164534
LBN Legal business name MIDWAY PHARMACY OF CLARKSON INC
Authorized official TREVOR RAY - (SECRETARY)
Entity Organization
Organization subpart 1 No
Enumeration date 05/21/2008
Last updated 11/29/2016 - About 10 years ago
Identifiers
KY License # P07254
KY Medicaid 7100165160
KY Medicaid 7100236160
Other 2035134 PK
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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