SRC PHARMACY LLC (NPI# 1740248616) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740248616 |
| Entity Type | Organization |
| Organization Name | SRC PHARMACY LLC |
| Other Organization Name | RESIDENTIAL CRF |
| Practice Address |
2600 Western Ave Connersville IN 47331-1803 |
| Practice Telephone | 7658256800 |
| Practice Fax Number | 7658270011 |
| Mailing Telephone | 7658256800 |
| Mailing Fax Number | 7658270011 |
| Enumeration Date | 2006-05-02 |
| Last Update Date | 2019-12-05 |
| Authorized Official Name | MR. JASON C ALLEN (PHARMACIST) |
| Authorized Official Telephone | 7658256800 |
| Authorized Official Credential | RPH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336L0003X |
Pharmacy Specialization: Long Term Care Pharmacy |
Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 200454050A | 05 |
| Other Name | Type Code |
|---|---|
| RESIDENTIAL CRF | Other Name - Individual/Organization |
| Street Address |
2600 WESTERN AVE |
| City | CONNERSVILLE |
| State | IN |
| Zip Code | 47331-1803 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013528256 | Corinne Barrett | Nurse Practitioner | 2600 Western Ave, Connersville, IN 47331-1803 | 2020-08-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275062630 | Williams Creek Health Center | Chiropractor | 685 S Co Rd 350 W, Connersville, IN 47331 | 2017-06-08 |
| 1801275201 | Americas Best Foot and Ankle Specialists | Podiatrist | 1475 East State Road 44 Suite 7., Whitewater Valley Medical Center, Connersville, IN 47331 | 2015-05-19 |
| 1508027269 | Kevin Andrew Yaryan | Optometrist | 522 N Eastern Ave, Connersville, IN 47331 | 2008-06-24 |
| 1477694602 | Residential Crf, Inc. | Intermediate Care Facility, Mentally Retarded | 556 S Co Rd 550 W, Connersville, IN 47331 | 2007-02-09 |
| 1316024904 | Mark Milton Wynn | Chiropractor | 208 W 20th St, Connersville, IN 47331 | 2006-11-01 |
| 1356368104 | Fayette County Government | Clinic/Center | 401 Central Ave, Connersville, IN 47331 | 2006-07-17 |
| 1760437818 | Karl Phillip Greene | Optometrist | 2045 Virginia Avenue, Connersville, IN 47331 | 2006-05-24 |
| 1225098825 | Fayette Memorial Hospital Assoc Inc | Clinic/Center | 3542 N Western Ave, Connersville, IN 47331 | 2006-03-27 |
| 1437118973 | Jereme Shawn Pflum | Chiropractor | 685 S. C.r. 350 W, Connersville, IN 47331 | 2006-03-22 |
| 1649279258 | The Health and Hospital Corporation of Marion County | Skilled Nursing Facility | 281 S County Road 200 E, Connersville, IN 47331 | 2005-07-15 |
| Find all providers in zip 47331 | ||||
| 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 |
|---|---|---|---|---|
| 1003437609 | Damasius Inc | Pharmacy | 6949 Kennedy Ave Ste C, Hammond, IN 46323-2245 | 2020-05-05 |
| 1568099703 | In Touch of Indy, LLC | Pharmacy | 851 Columbia Rd Ste 190, Plainfield, IN 46168-7587 | 2020-03-26 |
| 1669030102 | Meds To You LLC | Pharmacy | 8250 Bash St Ste A3, Indianapolis, IN 46250-1938 | 2019-05-30 |
| 1083188973 | Circle City Pharmacy, LLC | Pharmacy | 65 E Garner Rd Ste 200, Brownsburg, IN 46112-7867 | 2019-01-14 |
| 1174091557 | Rubicon Dtp, LLC | Pharmacy | 5751 W 73rd St # A, Indianapolis, IN 46278-1741 | 2018-11-05 |
| 1962870295 | Pca Corrections LLC | Pharmacy | 1740 Williamsburg Dr Ste A, Jeffersonville, IN 47130-8066 | 2015-09-03 |
| 1407235013 | Cppltc LLC | Pharmacy | 482 W Navajo St Ste B, West Lafayette, IN 47906-1940 | 2015-05-28 |
| 1871986596 | N&m Investments | Pharmacy | 30 S Water St Ste B, Franklin, IN 46131-2316 | 2015-03-05 |
| 1588911895 | United Rx, LLC | Pharmacy | 2325 Pointe Pkwy, Carmel, IN 46032-3294 | 2012-08-07 |
| 1265674097 | Pauls Pharmacy Inc | Pharmacy | 4111 N Saint Joseph Ave, Evansville, IN 47720-1206 | 2009-03-25 |
| Find all providers with the same taxonomy | ||||
| City | CONNERSVILLE |
| Zip Code | 47331 |
Please comment or provide details below to improve the information on SRC 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.