The Medicine Shoppe
LBN: Larry J & Bonnie P Russell
The Medicine Shoppe is an health care organization with primary practice located at 910 N Dixie Ave Ste 105 , Elizabethtown KY 42701-2519. 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.
Larry J & Bonnie P Russell can be contacted via phone (270) 769-3717, or through Russell, Larry via phone (270) 769-3717.
Contact Information
Primary practice address
910 N Dixie Ave Ste 105
Elizabethtown KY 42701-2519
Phone: (270) 769-3717
Fax: (270) 769-2887
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Pharmacy | 333600000X | P01397 | Kentucky |
| Suppliers / Community/Retail Pharmacy | 3336C0003X | Kentucky |
Profile Details
| NPI number | 1710977442 |
|---|---|
| LBN Legal business name | Larry J & Bonnie P Russell |
| DBA Doing business as | The Medicine Shoppe |
| Authorized official | Russell, Larry R.PH. |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Oct 25th, 2005 |
| Last updated | Mar 7th, 2023 - about last year |
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 | 1710977442 | NPPES |
| Kentucky | Other | 1813131 | NCPDP # |
| Kentucky | MEDICAID | 5401676100 | NCPDP # |
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