Organization Name:  PENDLETON PHARMACIST GROUP INC


Practice Location:
1100 WEST SHELBY STREET  FALMOUTH, KY 41040 US
Tel: 859-654-3232  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

Primary	Code	Category/Description	State	License Number
N	3336C0003X	Suppliers Pharmacy Community/Retail Pharmacy
N	332B00000X	Suppliers Durable Medical Equipment & Medical Supplies	KY	743031560
N	332B00000X	Suppliers Durable Medical Equipment & Medical Supplies	KY	P07273
Y	333600000X	Suppliers Pharmacy	KY	P07273

Other Provider Identifiers:

Issuer	Number	State	Type
	7100056430	KY	05
	54030739	KY	05
	90030966	KY	05

Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin