SOUTHALL PHARMACY PLLC (NPI# 1417119157) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417119157 |
| Entity Type | Organization |
| Organization Name | SOUTHALL PHARMACY PLLC |
| Other Organization Name | EXTENCARE |
| Practice Address |
110 E Main St Lebanon KY 40033-1235 |
| Practice Telephone | 2706999251 |
| Mailing Telephone | 2706999251 |
| Enumeration Date | 2008-06-25 |
| Last Update Date | 2008-06-25 |
| Authorized Official Name | MR. FRANCIS W SOUTHALL JR. (OWNER) |
| Authorized Official Telephone | 2706923111 |
| Authorized Official Credential | RPH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | P07263 | KY | Suppliers |
| N | 332BN1400X |
Durable Medical Equipment & Medical Supplies Specialization: Nursing Facility Supplies |
P07263 | KY | Suppliers |
| Y | 3336L0003X |
Pharmacy Specialization: Long Term Care Pharmacy |
P07263 | KY | Suppliers |
| Other Name | Type Code |
|---|---|
| Extencare | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497871859 | Southall Pharmacy Pllc | Durable Medical Equipment & Medical Supplies | 325 W Walnut St, Suite 500, Lebanon, KY 40033-1377 | 2007-03-21 |
| Street Address |
110 E MAIN ST |
| City | LEBANON |
| State | KY |
| Zip Code | 40033-1235 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538636311 | One Cross Health Clinic, Inc. | Clinic/Center | 305 Koehler Drive, Lebanon, KY 40033 | 2018-10-30 |
| 1467848952 | Kelly Renee Deatley | Family Medicine | 325 W Walnut St Ste 600, Lebanon, KY 40033 | 2015-04-10 |
| 1003204892 | Mmhh, LLC | Clinic/Center | 135 E. Martin Luther King Ave., Lebanon, KY 40033 | 2014-12-31 |
| 1194964510 | Gregory W. Schall, Do, Pllc | Family Medicine | 312 W High Street, Lebanon, KY 40033 | 2009-02-09 |
| 1780859553 | Wal-mart Stores East, Lp | Eyewear Supplier (Equipment, not the service) | 2136 Campbellsville Road, Lebanon, KY 40033 | 2008-04-23 |
| 1144491234 | William Duley IIi | Dentist | 219 West Main St, Lebanon, KY 40033 | 2008-03-17 |
| 1891965927 | Dana Michelle Logsdon | Nurse Practitioner | 727 W. Main St., Lebanon, KY 40033 | 2008-03-05 |
| 1669523684 | The Childrens Clinic, Pllc. | Pediatrics | 420 Loretta Road, Lebanon, KY 40033 | 2007-01-16 |
| 1215022348 | Marion County Anesthesia Associates Pllc | Nurse Anesthetist, Certified Registered | 320 Loretto Road, Lebanon, KY 40033 | 2006-10-04 |
| 1568479426 | Daniel Earl Bailey Jr. | Specialist | 420 Loretto Rd, Suite 600, Lebanon, KY 40033 | 2006-08-02 |
| Find all providers in zip 40033 | ||||
| Taxonomy Code | 3336L0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Long Term Care Pharmacy |
| A pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities for mentally retarded, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements. |
| 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 |
|---|---|---|---|---|
| 1245388768 | Pharmscript of Tn LLC | Pharmacy | 709 Castle Ht Court, Lebanon, TN 37087 | 2007-01-08 |
| 1790879526 | Joe's Pharmacy Inc | Pharmacy | 489 S Jefferson Ave, Lebanon, MO 65536-3261 | 2006-10-03 |
| 1740233311 | Rx Shops Inc. | Pharmacy | 223 E 7th St, Lebanon, MO 65536-2706 | 2006-05-18 |
| 1952943375 | Kratzer Pharmacy Inc. | Pharmacy | 118 W Main St Ste D, Lebanon, OH 45036-2098 | 2019-10-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043846769 | C D S 10 Pharmacy LLC | Pharmacy | 1308 Ashley Circle, Bowling Green, KY 42104 | 2020-03-13 |
| 1871133116 | Tompkinsville Drugs LLC | Pharmacy | 1513 Edmonton Rd, Tompkinsville, KY 42167-9402 | 2020-01-15 |
| 1407498546 | Andrews Packaging Pharmacy, Inc | Pharmacy | 10101 Taylorsville Rd Ste 103, Louisville, KY 40299-3663 | 2019-10-10 |
| 1578104287 | Medwiz of Kentucky, LLC | Pharmacy | 116 Venture Ct Suites 4-5-6, Lexington, KY 40511-2625 | 2019-10-03 |
| 1164994315 | Rice Drugs, Inc. | Pharmacy | 125 Veller Drive, Beaver Dam, KY 42320-8955 | 2018-12-28 |
| 1174946875 | Orion Rx Kentucky LLC | Pharmacy | 13100 Magisterial Dr Ste 102, Louisville, KY 40223-5185 | 2014-01-31 |
| 1053757393 | Pharm-save, Inc. | Pharmacy | 13040 Eastgate Park Way Ste 105, Louisville, KY 40223-3915 | 2013-05-14 |
| 1427328459 | Highland Pharmacy Inc | Pharmacy | 301 Rogers Rd, Glasgow, KY 42141-4110 | 2012-01-06 |
| 1801164348 | Apothecare Pharmacy of Elizabethtown P S C | Pharmacy | 189 E Lincoln Trail Blvd, Radcliff, KY 40160-1253 | 2011-12-12 |
| 1386958866 | Bluegrass Long Term Care | Pharmacy | 2187 Lexington Rd Ste 1, Richmond, KY 40475-7919 | 2010-07-27 |
| Find all providers with the same taxonomy | ||||
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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.