Provider Demographics
NPI:1730264029
Name:RUMFELT DRUG INC
Entity type:Organization
Organization Name:RUMFELT DRUG INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PHCST
Authorized Official - Prefix:
Authorized Official - First Name:ARLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:DICK
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:270-236-2889
Mailing Address - Street 1:PO BOX 297
Mailing Address - Street 2:
Mailing Address - City:HICKMAN
Mailing Address - State:KY
Mailing Address - Zip Code:42050-0297
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2009 S 7TH ST
Practice Address - Street 2:
Practice Address - City:HICKMAN
Practice Address - State:KY
Practice Address - Zip Code:42050-1841
Practice Address - Country:US
Practice Address - Phone:270-236-2588
Practice Address - Fax:270-236-9162
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYP06834333600000X
3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered333600000XSuppliersPharmacy
Not Answered3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
1805259OtherOTHER ID NUMBER-COMMERCIAL NUMBER
KY54004999Medicaid