Provider Demographics
NPI:1144502287
Name:FAMILY DISCOUNT DRUGS
Entity type:Organization
Organization Name:FAMILY DISCOUNT DRUGS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:MARCUM
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM-D
Authorized Official - Phone:606-248-8900
Mailing Address - Street 1:3603 CUMBERLAND AVE
Mailing Address - Street 2:
Mailing Address - City:MIDDLESBORO
Mailing Address - State:KY
Mailing Address - Zip Code:40965-2613
Mailing Address - Country:US
Mailing Address - Phone:606-248-8900
Mailing Address - Fax:606-248-8901
Practice Address - Street 1:3603 CUMBERLAND AVE
Practice Address - Street 2:
Practice Address - City:MIDDLESBORO
Practice Address - State:KY
Practice Address - Zip Code:40965-2613
Practice Address - Country:US
Practice Address - Phone:606-248-8900
Practice Address - Fax:606-248-8901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-14
Last Update Date:2020-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
KYP074713336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2132415OtherPK
KY7100179620Medicaid