Grider Drug Llc

LBN: Grider Drug Llc
Grider Drug Llc is an health care organization with primary practice located at 124 Dowell Rd , Russell Springs KY 42642-4278. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Grider Drug Llc can be contacted via phone (270) 866-2686, or through Grider, Eric via phone (270) 866-2686.

Contact Information

Primary practice address
124 Dowell Rd Russell Springs KY 42642-4278
Phone: (270) 866-2686
Fax: (270) 866-6566
Website:
Map and Directions
Authorized official contact:
Name: Grider, Eric
Phone: (270) 866-2686

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X P01425 Kentucky

Profile Details

NPI number 1164485702
LBN Legal business name Grider Drug Llc
DBA Doing business as Grider Drug Llc
Authorized official Grider, Eric
Entity Organization
Organization subpart 1 No
Enumeration date Apr 6th, 2006
Last updated Mar 26th, 2009 - about 16 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1164485702 NPPES
Kentucky MEDICAID 54008552
Kentucky Other 1813799

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