CLOVER FORK OUTPATIENT MEDICAL PROJECT INC (NPI# 1376565226) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376565226 |
| Entity Type | Organization |
| Organization Name | CLOVER FORK OUTPATIENT MEDICAL PROJECT INC |
| Other Organization Name | CLOVER FORK CLINICAL PHARMACY |
| Practice Address |
101 Chad St Evarts KY 40828 |
| Mailing Address |
Po Box 39 Evarts KY 40828-0039 |
| Practice Telephone | 6068372100 |
| Practice Fax Number | 6068379389 |
| Mailing Telephone | 6068372108 |
| Mailing Fax Number | 6068379389 |
| Enumeration Date | 2006-07-23 |
| Last Update Date | 2015-10-21 |
| Authorized Official Name | MR. BRITT LEWIS JR. (ADMINISTRATOR) |
| Authorized Official Telephone | 6068372108 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | P01273 | KY | Suppliers |
| N | 332BP3500X |
Durable Medical Equipment & Medical Supplies Specialization: Parenteral & Enteral Nutrition |
P01273 | KY | Suppliers |
| Y | 333600000X | Pharmacy | P01273 | KY | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | 54034913 | 05 |
| Other Name | Type Code |
|---|---|
| Clover Fork Clinical Pharmacy | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497195036 | Clover Fork Outpatient Medical Project Inc | Clinic/Center | 209 E Mound St, Harlan, KY 40831-2321 | 2013-06-27 |
| 1811939366 | Clover Fork Outpatient Medical Project Inc | Clinic/Center | 101 Chad St, Clover Fork Clinic, Evarts, KY 40828-8200 | 2006-06-11 |
| Street Address |
101 CHAD ST |
| City | EVARTS |
| State | KY |
| Zip Code | 40828 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174520498 | Johnny Lee Mcgill | Pharmacist | 101 Chad St, Evarts, KY 40828 | 2005-07-01 |
| 1336576677 | Eric N Roberts | Physician Assistant | 101 Chad St, Clover Fork Clinic, Evarts, KY 40828-8200 | 2013-10-01 |
| 1700810314 | Rachel R Eubank | Family Medicine | 101 Chad St, Cloverfork Clinic, Evarts, KY 40828-0039 | 2006-07-10 |
| 1619901220 | John D Miller | Internal Medicine | 101 Chad St, Cloverfork Clinic, Evarts, KY 40828-0039 | 2006-07-10 |
| 1245264852 | Sharon M Colton | Family Medicine | 101 Chad St, Cloverfork Clinic, Evarts, KY 40828-0039 | 2006-07-10 |
| 1164466066 | Michael W Napier | Physician Assistant | 101 Chad St, Cloverfork Clinic, Evarts, KY 40828-0039 | 2006-06-15 |
| 1811939366 | Clover Fork Outpatient Medical Project Inc | Clinic/Center | 101 Chad St, Clover Fork Clinic, Evarts, KY 40828-8200 | 2006-06-11 |
| 1720070089 | William Morgan Miller | Physician Assistant | 101 Chad St, Evarts, KY 40828-0039 | 2005-08-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730224288 | Cumberland Valley Dist. Health Dept. | Public Health or Welfare | 138 Yocum Street, Evarts, KY 40828 | 2007-02-21 |
| 1316089337 | Cumberland Valley Dist Health Dept | Public Health or Welfare | 115 Yocum Street, Evarts, KY 40828 | 2007-02-13 |
| 1043852106 | Melanie Buchanan-manning | Pharmacy Technician | 129 S Main St, Evarts, KY 40828 | 2019-10-10 |
| 1427351261 | Lori L Shope | Dietitian, Registered | 101 Chad Street, Evarts, KY 40828-0039 | 2010-12-17 |
| 1609971969 | Mia R Sellars | Dentist | Clover Fork Clinic, 101 Chad St, Evarts, KY 40828-0039 | 2006-09-13 |
| 1104262104 | Harlan County Health Department/evarts Elementary School | Public Health or Welfare | 132 Keister St, Evarts, KY 40828-5908 | 2013-05-16 |
| 1124583331 | Barbara Kaye Middleton | Nurse Practitioner | 118 Howard St, Evarts, KY 40828-5936 | 2019-02-01 |
| 1073962874 | My Time Counseling Services for Professionals, P.l.l.c. | Preferred Provider Organization | 383 Sals Branch Rd, Evarts, KY 40828-6484 | 2016-06-13 |
| Taxonomy Code | 333600000X |
| Grouping | Suppliers |
| Classification | 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. |
| 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: added definition] |
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| 1851925986 | Bardwell Pharmacy LLC | Pharmacy | 178 Us Highway 51 N, Bardwell, KY 42023-9096 | 2020-02-27 |
| 1114563319 | Inspire Rx Pharmacy LLC | Pharmacy | 950 N Mulberry St Ste 100a, Elizabethtown, KY 42701-3629 | 2019-11-22 |
| 1629559224 | Villagemd Clinicals Pharmacy Kentucky | Pharmacy | 1000 S 12th St Ste A, Murray, KY 42071 | 2018-08-22 |
| 1376029025 | Elizabeth Prather | Pharmacy | 7220 Burlington Pike Ste I, Florence, KY 41042-1586 | 2018-07-16 |
| 1942791231 | Patek Pharmacy LLC | Pharmacy | 8600 Preston Hwy, Louisville, KY 40219-5306 | 2018-05-23 |
| 1184122160 | Saint Joseph Health System, Inc. | Pharmacy | 120 N Eagle Creek Dr Ste 101, Suite 101, Lexington, KY 40509-1827 | 2018-01-25 |
| 1326556853 | Jumeirah Global LLC | Pharmacy | 604 Crystal Pl Ste 3, La Grange, KY 40031-1297 | 2018-01-18 |
| 1487165478 | Tpc Martin Inc | Pharmacy | 1102 Kentucky Rt 122, Martin, KY 41649 | 2017-10-17 |
| 1326565755 | Aadhya Healthcare LLC | Pharmacy | 2713 Fort Campbell Blvd, Hopkinsville, KY 42240-4940 | 2017-08-25 |
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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.