MIKELS DRIVE IN PHARMACY INC (NPI# 1700885001) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700885001 |
| Entity Type | Organization |
| Organization Name | MIKELS DRIVE IN PHARMACY INC |
| Other Organization Name | FOUNTAIN SQUARE PHARMACY |
| Practice Address |
1928 Cumberland Ave Middlesboro KY 40965-1231 |
| Practice Telephone | 6062481052 |
| Practice Fax Number | 6062486598 |
| Mailing Telephone | 6062481052 |
| Mailing Fax Number | 6062486598 |
| Enumeration Date | 2005-07-19 |
| Last Update Date | 2016-06-28 |
| Authorized Official Name | MAURICE MCGLONE (PHARMD) |
| Authorized Official Telephone | 6062481052 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
P07708 | KY | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2153658 | 01 | |
| TN | 4582114 | 05 | |
| KY | 54011945 | 05 |
| Other Name | Type Code |
|---|---|
| Fountain Square Pharmacy | Doing Business As Name - Organization |
| Street Address |
1928 CUMBERLAND AVE |
| City | MIDDLESBORO |
| State | KY |
| Zip Code | 40965-1231 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790078327 | Marcena Mikel Byrne II | Pharmacist | 1928 Cumberland Ave, Middlesboro, KY 40965-1231 | 2011-05-16 |
| 1972787885 | Mikels Drive In Pharmacy | Durable Medical Equipment & Medical Supplies | 1928 Cumberland Ave, Middlesboro, KY 40965-1231 | 2007-12-27 |
| 1609050517 | Mikels Drive In Pharmacy | Pharmacy | 1928 Cumberland Ave, Middlesboro, KY 40965-1231 | 2007-12-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396387064 | Christopher Bruce Ellison | Social Worker | 809 19th Street, Middlesboro, KY 40965 | 2019-10-14 |
| 1982255030 | Johnny Wade Nantz II | Case Manager/Care Coordinator | 809 N 19th St, Middlesboro, KY 40965 | 2019-09-20 |
| 1558827774 | August Pediatrics, LLC | Pediatrics | 123 N 19th St Ste 302, Middlesboro, KY 40965 | 2019-02-12 |
| 1558843227 | Bethany Lauren Wade | Case Manager/Care Coordinator | 19th St, 809, Middlesboro, KY 40965 | 2018-08-30 |
| 1124521505 | Sonya Joyce Mcneil | Speech-Language Pathologist | Kidabilities Pediatric Therapy Center, 2801 Highway 25e, Suite 98, Middlesboro, KY 40965 | 2018-03-13 |
| 1518499862 | Vikki Lynn Johnson | Case Manager/Care Coordinator | 809 North 19th Street, Middlesboro, KY 40965 | 2017-03-28 |
| 1184164287 | Wilson Jeffrey | Occupational Therapist | Address: 235 New Wilson Lane, Middlesboro, KY 40965 | 2017-03-08 |
| 1447797444 | Lesha Loretta Williams | Physician Assistant | 2004 Cumberland Ave Ste 100, Middlesboro, KY 40965 | 2017-01-27 |
| 1619423910 | Audra Anissa Hall | Physical Therapist | 108 Turner Lane, Middlesboro, KY 40965 | 2016-08-28 |
| 1700332061 | Tammy Mclain | Counselor | Selfrefind 809 North 19th Street, Middlesboro, KY 40965 | 2016-08-28 |
| Find all providers in zip 40965 | ||||
| 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 |
|---|---|---|---|---|
| 1376161588 | Arh Mary Breckinridge Health Services, Inc. | Pharmacy | 3504 West Cumberland Ave, Middlesboro, KY 40965-2612 | 2020-07-14 |
| 1396079349 | Bowkirk Medical | Pharmacy | 3004 Cumberland Ave Ste 101, Middlesboro, KY 40965-2343 | 2009-09-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306445259 | Middletown Pharmacist Group | Pharmacy | 11601 Shelbyville Rd Ste B, Louisville, KY 40243-1309 | 2020-10-21 |
| 1144828724 | Pharmacy Care Center | Pharmacy | 10616 South Ky Hwy 15, Scuddy, KY 41760 | 2020-10-15 |
| 1497361208 | Kerry Hettinger | Pharmacy | 1114 Schiller Ave, Louisville, KY 40204-1946 | 2020-09-17 |
| 1114539822 | B&b Pharmacy, Pllc | Pharmacy | 126 Shadowmeade Lane, Unit 2, Mount Washington, KY 40047 | 2020-08-24 |
| 1073139531 | Cornerstone Care Associates | Pharmacy | 1509 1/2 Lexington Rd Ste 2, Richmond, KY 40475-1060 | 2020-06-21 |
| 1912523614 | Oldham Pharmacist Group | Pharmacy | 1000 Cherrywood Pl Ste 100, La Grange, KY 40031-8927 | 2020-06-18 |
| 1578187209 | St. Elizabeth Medical Center, Inc. | Pharmacy | 1 Medical Village Dr., Edgewood, KY 41017 | 2020-05-28 |
| 1922629997 | Classic Specialty Pharmacy Pllc | Pharmacy | 3582 Springhurst Blvd, Louisville, KY 40241-4141 | 2020-05-01 |
| 1346860095 | Dupont Pharmacy, LLC | Pharmacy | 3924 S Dupont Sq Ste D, Louisville, KY 40207-5912 | 2020-04-23 |
| 1477188464 | Redding Drug LLC | Pharmacy | 431 Redding Rd Ste 140, Lexington, KY 40517-2534 | 2020-03-10 |
| Find all providers with the same taxonomy | ||||
| City | MIDDLESBORO |
| Zip Code | 40965 |
Please comment or provide details below to improve the information on MIKELS DRIVE IN PHARMACY INC.
| 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.