Grider Drug #1 Llc
LBN: Grider Drug #1 Llc
Grider Drug #1 Llc is an health care organization with primary practice located at 539 Main St , Russell Springs KY 42642-4357. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty.
Grider Drug #1 Llc can be contacted via phone (270) 866-6477, or through Grider, Anna Mae via phone (270) 866-6477.
Contact Information
Primary practice address
539 Main St
Russell Springs KY 42642-4357
Phone: (270) 866-6477
Fax: (270) 866-5307
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Durable Medical Equipment & Medical Supplies | 332B00000X | P00682 | |
| Suppliers / Community/Retail Pharmacy | 3336C0003X | P00682 | Kentucky |
Profile Details
| NPI number | 1033172119 |
|---|---|
| LBN Legal business name | Grider Drug #1 Llc |
| DBA Doing business as | |
| Authorized official | Grider, Anna Mae |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Apr 10th, 2006 |
| Last updated | Mar 5th, 2008 - about 17 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1033172119 | NPPES |
| Kentucky | MEDICAID | 90009978 | |
| Kentucky | MEDICAID | 54008453 | |
| Kentucky | MEDICAID | 45002490 |
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