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Contact Information

J W PHARMACY
817 MAIN ST
BENTON, KY42025-1240
 Phone: 270-527-9374
 Fax: 270-527-3152
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pharmacy

333600000X 58 Medical Supply Company with Pharmacist
 

Nursing Facility/Intermediate Care Facility

313M00000X A3[10] Other Nursing Facility
 

Skilled Nursing Facility

314000000X A1[8] Skilled Nursing Facility
Indicates primary specialty

NPI Profile & details for J W PHARMACY

NPI Number 1417067729
LBN Legal business name J W PHARMACY
Authorized official JAMES WISEMAN - (OWNER PRES)
Entity Organization
Organization subpart 1 No
Enumeration date 08/30/2006
Last updated 10/11/2016 - About 10 years ago
Identifiers
KY License # 00663
KY Medicaid 54009600
KY Other 1801100 NABP
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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