ETOWN PHARMACY LLC (NPI# 1295020741) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295020741 |
| Entity Type | Organization |
| Organization Name | ETOWN PHARMACY LLC |
| Other Organization Name | ETOWN PHARMACY |
| Practice Address |
914 N Dixie Ave Ste 103 Elizabethtown KY 42701-2536 |
| Practice Telephone | 2709001583 |
| Practice Fax Number | 2709001594 |
| Mailing Telephone | 2709001583 |
| Mailing Fax Number | 2709001594 |
| Enumeration Date | 2011-06-13 |
| Last Update Date | 2020-07-01 |
| Authorized Official Name | MOHAMMED SHAJIUDDIN (OWNER, ADMINISTRATOR) |
| Authorized Official Telephone | 6156866420 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| N | 333600000X | Pharmacy | Suppliers | ||
| N | 3336C0004X |
Pharmacy Specialization: Compounding Pharmacy |
Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
P07451 | KY | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2130699 | 01 | |
| KY | 7100170610 | 05 |
| Other Name | Type Code |
|---|---|
| Etown Pharmacy | Doing Business As Name - Organization |
| Street Address |
914 N DIXIE AVE STE 103 |
| City | ELIZABETHTOWN |
| State | KY |
| Zip Code | 42701-2536 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720693104 | James G. Thornton | Specialist/Technologist, Other | 2409 Ring Road, Suite 106, Elizabethtown, KY 42701 | 2020-09-11 |
| 1033720727 | Rebecca Williams | Pharmacist | 1602 N Dixie Highway, Elizabethtown, KY 42701 | 2020-08-14 |
| 1245855709 | Mckenzie Jo Clemons | Speech-Language Pathologist | 107 Financial Drive, Elizabethtown, KY 42701 | 2020-06-10 |
| 1215565825 | Christina Nichole Hobson | Peer Specialist | 413 E Dixie Ste 106, Elizabethtown, KY 42701 | 2020-03-30 |
| 1336701275 | Cassandra Elizabeth Baker | Nurse Practitioner | 2005 N. Dixie Highway, Elizabethtown, KY 42701 | 2019-07-01 |
| 1487134276 | Ryan Leon Hogan | Marriage & Family Therapist | 1106 Tunnel Hill Road, Suite 100, Elizabethtown, KY 42701 | 2018-08-21 |
| 1033623921 | Kayla Russell | Behavior Technician | 529 Westport Road, Elizabethtown, KY 42701 | 2017-11-30 |
| 1578087128 | Brenda Gale Nunn | Case Manager/Care Coordinator | 2600 Ring Road, Elizabethtown, KY 42701 | 2017-07-26 |
| 1013451277 | Chelsea Danielle Thorn | Nurse Practitioner | 2005 N. Dixie Hwy, Elizabethtown, KY 42701 | 2016-12-07 |
| 1003364597 | Joseph Michael Senay | Pharmacist | 521 Robinbrooke Dr., Cancer Care Center of Hardin Memorial Hospital, Elizabethtown, KY 42701 | 2016-09-14 |
| Find all providers in zip 42701 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881107985 | Apothecare Pharmacy of Elizabethtown Psc | Pharmacy | 1016 N Mulberry St, Elizabethtown, KY 42701-2173 | 2017-11-10 |
| 1659726586 | K Mart Pharmacy #4753 | Pharmacy | 1809 N Dixie Ave, Elizabethtown, KY 42701-9451 | 2016-04-28 |
| 1154758514 | Adio Health Management Solutions | Pharmacy | 150 Raleigh Dr Ste 3, Elizabethtown, KY 42701-7139 | 2013-10-01 |
| 1043455264 | Sam's East Inc | Pharmacy | 1500 Ring Rd, Elizabethtown, KY 42701-7984 | 2008-12-03 |
| 1558450544 | Sloan's Pharmacy, Inc. | Pharmacy | 428 Cloverleaf Rd, Elizabethtown, PA 17022-9320 | 2006-10-11 |
| 1134223977 | Pennsylvania Cvs Pharmacy, L.L.C. | Pharmacy | 1575 S Market St, Elizabethtown, PA 17022-2880 | 2006-09-12 |
| 1073616744 | North Carolina Cvs Pharmacy LLC | Pharmacy | 371 S Polar St, Elizabethtown, NC 28337 | 2006-09-07 |
| 1609882166 | Walgreen Co | Pharmacy | 1008 N Mulberry St, Elizabethtown, KY 42701-2037 | 2006-08-01 |
| 1124033360 | Walgreen Co | Pharmacy | 1602 N Dixie Ave, Elizabethtown, KY 42701-2682 | 2006-07-29 |
| 1336529262 | Ingram & Ball, Pllc | Pharmacy | 2412 Ring Rd Ste 200, Elizabethtown, KY 42701-5913 | 2015-06-05 |
| Find all providers in ELIZABETHTOWN | ||||
| City | ELIZABETHTOWN |
| Zip Code | 42701 |
Please comment or provide details below to improve the information on ETOWN PHARMACY LLC.
| 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.