Lake Cumberland Pharmacy #2
LBN: Lake Cumberland Pharmacy Llc
Lake Cumberland Pharmacy #2 is an health care organization with primary practice located at 124 Dowell Rd , Russell Springs KY 42642-4278. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Parenteral & Enteral Nutrition, Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty.
Lake Cumberland Pharmacy Llc can be contacted via phone (270) 866-2686, or through Grider, Jonathan via phone (270) 858-6400.
Contact Information
Primary practice address
124 Dowell Rd
Russell Springs KY 42642-4278
Phone: (270) 866-2686
Fax: (270) 866-6566
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Parenteral & Enteral Nutrition | 332BP3500X | ||
| Suppliers / Pharmacy | 333600000X | ||
| Suppliers / Community/Retail Pharmacy | 3336C0003X | P07440 | Kentucky |
Profile Details
| NPI number | 1912201906 |
|---|---|
| LBN Legal business name | Lake Cumberland Pharmacy Llc |
| DBA Doing business as | Lake Cumberland Pharmacy #2 |
| Authorized official | Grider, Jonathan PHARMD |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jan 5th, 2011 |
| Last updated | Oct 7th, 2022 - about 3 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 | 1912201906 | NPPES |
| Other | 2128898 | PK | |
| MEDICAID | 7100171840 | PK |
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