Provider Demographics
NPI:1679380133
Name:WILSON FAMILY PHARMACY INC
Entity type:Organization
Organization Name:WILSON FAMILY PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MISS
Authorized Official - First Name:JIGNA
Authorized Official - Middle Name:G
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-688-0100
Mailing Address - Street 1:2845 W PARRISH AVE STE E
Mailing Address - Street 2:
Mailing Address - City:OWENSBORO
Mailing Address - State:KY
Mailing Address - Zip Code:42301-3337
Mailing Address - Country:US
Mailing Address - Phone:270-688-0100
Mailing Address - Fax:270-688-0700
Practice Address - Street 1:2845 W PARRISH AVE
Practice Address - Street 2:
Practice Address - City:OWENSBORO
Practice Address - State:KY
Practice Address - Zip Code:42301-3337
Practice Address - Country:US
Practice Address - Phone:270-688-0100
Practice Address - Fax:270-688-0700
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-17
Last Update Date:2024-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy