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Contact Information

MIDTOWN PHARMACY EXPRESS, LLC
500 N MAIN ST
BEAVER DAM, KY42320-1949
 Phone: 270-274-9224
 Fax: 270-274-9226
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community/Retail Pharmacy

3336C0003X 58 Medical Supply Company with Pharmacist
 

Compounding Pharmacy

3336C0004X 58 Medical Supply Company with Pharmacist
 

Durable Medical Equipment & Medical Supplies

332B00000X 54 Other Medical Supply Company
Indicates primary specialty

NPI Profile & details for MIDTOWN PHARMACY EXPRESS, LLC

NPI Number 1932442266
LBN Legal business name MIDTOWN PHARMACY EXPRESS, LLC
Authorized official JOHNATHAN FULLER - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 04/04/2013
Last updated 11/20/2013 - About 13 years ago
Identifiers
KY License # P07565
KY Medicaid 7100238220
KY Other P07565 PHARMACY LICENSE
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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