18D2162325 CLIA NUMBER - TOMPKINSVILLE DRUG COMPANY

Laboratory Demographics

CLIA Number: 18D2162325

Facility Name: TOMPKINSVILLE DRUG COMPANY

Facility Address:
1513 EDMONTON ROAD
TOMPKINSVILLE, KY
ZIP 42167
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Facility Phone Number: 270 487-6155

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1871133116

Taxonomy: 3336L0003X - Pharmacy
A pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements.

CLIA Record

Field Name	Field Value
CLIA Number	18D2162325
LAB Type	Pharmacy
Facility Name	TOMPKINSVILLE DRUG COMPANY
Street	1513 EDMONTON ROAD
City	TOMPKINSVILLE
State	KY
ZIP	42167
Phone	270 487-6155
CertificateType	4
CertificateEffectiveDate	2/20/2023
CertificateExpirationDate	2/19/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024