COMMONWEALTH OF KENTUCKY (NPI# 1124144456) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124144456 |
| Entity Type | Organization |
| Organization Name | COMMONWEALTH OF KENTUCKY |
| Other Organization Name | WESTERN STATE HOSPITAL PHARMACY |
| Practice Address |
2400 Russellville Road Hopkinsville KY 42240 |
| Practice Telephone | 2708896025 |
| Practice Fax Number | 2708895062 |
| Mailing Telephone | 2708896025 |
| Mailing Fax Number | 2708895062 |
| Enumeration Date | 2007-03-21 |
| Last Update Date | 2015-07-08 |
| Authorized Official Name | STEPHANIE CRAYCRAFT (DIRECTOR) |
| Authorized Official Telephone | 5027826243 |
| Is Organization Subpart | Y |
| Parent Organization Name | COMMONWEALTH OF KENTUCKY |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 3336L0003X |
Pharmacy Specialization: Long Term Care Pharmacy |
P05010 | KY | Suppliers |
| N | 3336L0003X |
Pharmacy Specialization: Long Term Care Pharmacy |
P06561 | KY | Suppliers |
| N | 1835P1300X |
Pharmacist Specialization: Psychiatric |
KY | Pharmacy Service Providers | |
| N | 1835G0303X |
Pharmacist Specialization: Geriatric |
KY | Pharmacy Service Providers | |
| Y | 183500000X | Pharmacist | KY | Pharmacy Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | 5402559800 | 05 | |
| KY | 54025598 | 05 |
| Other Name | Type Code |
|---|---|
| Western State Hospital Pharmacy | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043686900 | Commonwealth of Kentucky | Skilled Nursing Facility | 100 Veterans Drive, Radcliff, KY 40160 | 2015-08-14 |
| 1245657857 | Commonwealth of Kentucky | Clinic/Center | 2441 Us Highway 27, Somerset, KY 42501 | 2014-03-20 |
| 1730329897 | Commonwealth of Kentucky | Intermediate Care Facility, Mentally Retarded | 400 Eastwood, 2441 S. Hwy 27, Somerset, KY 42501 | 2009-03-03 |
| 1588804546 | Commonwealth of Kentucky | Intermediate Care Facility, Mentally Retarded | 400 Eastwood Dr, 2441 S. Hwy 27, Somersetq, KY 42501 | 2009-03-03 |
| 1770762833 | Commonwealth of Kentucky | Residential Treatment Facility, Physical Disabilities | 5659 Main St, Thelma, KY 41260-8609 | 2007-10-25 |
| 1396962551 | Commonwealth of Kentucky | Nursing Facility/Intermediate Care Facility | 200 Veterans Dr, Hazard, KY 41701-9484 | 2007-04-19 |
| 1194862599 | Commonwealth of Kentucky | Intermediate Care Facility, Mentally Retarded | 23524 Dawson Springs Rd, Dawson Springs, KY 42408-9205 | 2007-02-01 |
| 1083785125 | Commonwealth of Kentucky | Intermediate Care Facility, Mentally Retarded | 4401-4505 Louise Underwood Way, Louisville, KY 40216 | 2006-11-12 |
| 1689652513 | Commonwealth of Kentucky | Intermediate Care Facility, Mentally Retarded | 210 Meadows Dr, Mt Washington, KY 40047-6013 | 2005-12-30 |
| 1306824230 | Commonwealth of Kentucky | Intermediate Care Facility, Mentally Retarded | 9001 Park Wood Dr, Crestwood, KY 40014-9499 | 2005-12-30 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | COMMONWEALTH OF KENTUCKY - DEPARTMENT FOR LOCAL GOVERNMENT | 1024 Capital Center Dr Ste 340, Frankfort, KY 40601-7514 |
| Street Address |
2400 RUSSELLVILLE ROAD |
| City | HOPKINSVILLE |
| State | KY |
| Zip Code | 42240 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689214264 | Joshua Brian Yates | Pharmacist | 320 West 18th Street, Hopkinsville, KY 42240 | 2020-01-10 |
| 1629540950 | John J Tomasic | Nurse Practitioner | Jennie Stuart Medical Center, 320 W 18th Street, Hopkinsville, KY 42240 | 2018-12-27 |
| 1669962866 | Jeri Lynn Richardson | Developmental Therapist | 119 Forbes Dr, Hopkinsville, KY 42240 | 2018-05-14 |
| 1619416039 | Esther Caro | Case Manager/Care Coordinator | 400a Hammond Plz, Hopkinsville, KY 42240 | 2017-02-17 |
| 1780126532 | Jennifer R. Koranyi | Social Worker | 737b North Dr, Hopkinsville, KY 42240 | 2016-11-10 |
| 1043760937 | Inspira Therapy | Speech-Language Pathologist | 1110 South Main Street, Suite B, Hopkinsville, KY 42240 | 2016-10-04 |
| 1689026049 | Judy Greene Dba Greene Physical Therapy Services | Physical Therapist | 1910 South Virginia Ste., Ste. 108, Hopkinsville, KY 42240 | 2016-07-11 |
| 1083094932 | Cornell Memory Center | Clinic/Center | 101 North Drive, Hopkinsville, KY 42240 | 2015-06-05 |
| 1679978746 | Maulik V Patel | Pharmacist | 2713 A Fort Campbell Blvd, Hopkinsville, KY 42240 | 2014-10-30 |
| 1245630896 | Haregewoin Ezezew Baye | Dentist | 300 Cool Water Ct, Hopkinsville, KY 42240 | 2014-09-02 |
| Find all providers in zip 42240 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730789348 | Benjamin Gary Powell | Pharmacist | 3106 Canton Pike, Hopkinsville, KY 42240-1316 | 2020-11-01 |
| 1104425511 | Nathalie Ghnatios | Pharmacist | 417 Mcallister Cir, Hopkinsville, KY 42240-8749 | 2020-10-19 |
| 1689214264 | Joshua Brian Yates | Pharmacist | 320 West 18th Street, Hopkinsville, KY 42240 | 2020-01-10 |
| 1679978746 | Maulik V Patel | Pharmacist | 2713 A Fort Campbell Blvd, Hopkinsville, KY 42240 | 2014-10-30 |
| 1831398684 | Jacquelyn Jayne Strickland | Pharmacist | 2208 Fort Campbell Blvd, Hopkinsville, KY 42240-4665 | 2007-07-12 |
| 1972710382 | Arti Mahajan | Pharmacist | 2626 Fort Campbell Blvd, Hopkinsville, KY 42240-4939 | 2007-05-16 |
| 1104910835 | Mitzi Nichols Perkins | Pharmacist | 320 W 18th Street, Jennie Stuart Medical Center, Hopkinsville, KY 42240 | 2006-10-03 |
| 1477544278 | Robert Michael Cayce | Pharmacist | 1112 W 7th St, Hopkinsville, KY 42240-1818 | 2005-10-31 |
| 1528670601 | Bianca Yari Santiago | Pharmacist | 2901 Fort Campbell Blvd, Hopkinsville, KY 42240-4901 | 2020-08-19 |
| 1700406196 | Melissa Hale | Pharmacist | 300 Clinic Dr, Hopkinsville, KY 42240-4989 | 2020-04-25 |
| Find all providers in HOPKINSVILLE | ||||
| City | HOPKINSVILLE |
| Zip Code | 42240 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.