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Contact Information

GOFORTH PHARMACY LLC
406 BOGLE ST
SOMERSET, KY42503
 Phone: 606-677-1062
 Fax: 606-677-1182
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community/Retail Pharmacy

3336C0003X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for GOFORTH PHARMACY LLC

NPI Number 1356532352
LBN Legal business name GOFORTH PHARMACY LLC
Authorized official ROBERT GOFORTH - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 08/05/2007
Last updated 08/19/2009 - About 17 years ago
Identifiers
KY License # P07201
KY Medicaid 7100004180
KY Medicaid 7100025300
Other 1830288 NCPDP PROVIDER IDENTIFICATION NUMBER
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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