National Provider Identifier Database

CLOVER FORK OUTPATIENT MEDICAL PROJECT INC
Pharmacy

A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.


Contact Information

CLOVER FORK OUTPATIENT MEDICAL PROJECT INC
101 CHAD ST
EVARTS, KY40828
Phone: 606-837-2100
Fax: 606-837-9389
Website:
Specialty Taxonomy Code
* Pharmacy 333600000X
Durable Medical Equipment & Medical Supplies 332B00000X
Parenteral & Enteral Nutrition 332BP3500X

* Indicates primary specialty

NPI Profile & details for CLOVER FORK OUTPATIENT MEDICAL PROJECT INC

NPI Number 1376565226
Legal business name
LBN
CLOVER FORK OUTPATIENT MEDICAL PROJECT INC
Authorized official BRITT LEWIS - (ADMINISTRATOR)
Entity Organization
Organization subpart No
Enumeration date 07/23/2006
Last updated 10/21/2015 - About 11 years ago
Sole proprietor1 Not specified
Identifiers
  • KY License #: P01273
  • KY Medicaid: 54034913

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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