LAKE CUMBERLAND PHARMACY #2 (NPI# 1912201906) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912201906 |
| Entity Type | Organization |
| Organization Name | LAKE CUMBERLAND PHARMACY #2 |
| Other Organization Name | LAKE CUMBERLAND PHARMACY #2 |
| Practice Address |
124 Dowell Rd Russell Springs KY 42642-4278 |
| Mailing Address |
Po Box 72 Russell Springs KY 42642-0072 |
| Practice Telephone | 2708662686 |
| Practice Fax Number | 2708666566 |
| Mailing Telephone | 2708662686 |
| Enumeration Date | 2011-01-05 |
| Last Update Date | 2017-02-21 |
| Authorized Official Name | ERIC GRIDER (PIC) |
| Authorized Official Telephone | 2708662686 |
| Authorized Official Credential | BS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | Suppliers | ||
| N | 3336H0001X |
Pharmacy Specialization: Home Infusion Therapy Pharmacy |
Suppliers | ||
| N | 332BP3500X |
Durable Medical Equipment & Medical Supplies Specialization: Parenteral & Enteral Nutrition |
Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
P07440 | KY | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2128898 | 01 | |
| KY | 7100171840 | 05 |
| Other Name | Type Code |
|---|---|
| Lake Cumberland Pharmacy #2 | Doing Business As Name - Organization |
| Street Address |
124 DOWELL RD |
| City | RUSSELL SPRINGS |
| State | KY |
| Zip Code | 42642-4278 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942285556 | Sharon E Benson | Nurse Practitioner | 124 Dowell Rd, Russell Springs, KY 42642-4278 | 2005-12-07 |
| 1922414481 | Leann Dalton Cooper | Family Medicine | 124 Dowell Rd, Russell Springs, KY 42642 | 2014-07-05 |
| 1073936902 | Russell County Hospital | Clinic/Center | 124 Dowell Rd, Russell Springs, KY 42642-4278 | 2014-01-29 |
| 1235439654 | Eric B Grider | Pharmacist | 124 Dowell Rd, Russell Springs, KY 42642-4278 | 2010-11-01 |
| 1821276130 | Liesel C Grentz | Family Medicine | 124 Dowell Rd, Russell Springs, KY 42642-4278 | 2008-02-08 |
| 1982809695 | Russell Co Hospital Medical Arts Lab | Clinical Medical Laboratory | 124 Dowell Rd, Russell Springs, KY 42642-4278 | 2007-06-21 |
| 1356443477 | John Kilgallin M.d. | Family Medicine | 124 Dowell Rd, Russell Springs, KY 42642-4278 | 2006-09-01 |
| 1235188772 | Richard Stayton Miles | Family Medicine | 124 Dowell Rd, Russell Springs, KY 42642-4278 | 2006-05-10 |
| 1164485702 | Grider Drug LLC | Pharmacy | 124 Dowell Rd, Russell Springs, KY 42642-4278 | 2006-04-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730645490 | New Hope Counseling Services L.l.c | Psychologist | 330 Roy Drive, Russell Springs, KY 42642 | 2019-02-18 |
| 1629459912 | Ephraim Mcdowell Health Resources,inc | Physician Assistant | 92 Jt Petty Drive, Ste 300, Russell Springs, KY 42642 | 2015-06-12 |
| 1619397775 | Terri Susanne Jones Watkins Odpsc | Optometrist | 24 Caden Way, Suite 2, Russell Springs, KY 42642 | 2014-04-16 |
| 1548512247 | Charles Lenwood Gore | Pharmacist | 1372 Snow Rd, Russell Springs, KY 42642 | 2012-10-05 |
| 1407125016 | Avante Garde Health Centers, LLC | Clinic/Center | 72 Joe T Pettey Dr, Suite B, Russell Springs, KY 42642 | 2011-12-28 |
| 1821392515 | Southern Kentucky Medical Associates, Psc | Nurse Practitioner | 72 Joe T. Pettey Dr, Russell Springs, KY 42642 | 2011-01-10 |
| 1801106620 | Premiertox, Inc. | Clinical Medical Laboratory | 2431 Lakeway Drive, Suite A1, Russell Springs, KY 42642 | 2010-10-14 |
| 1639404593 | Rx Drug Monitoring Laboratory, LLC | Clinical Medical Laboratory | 660 Lakeway Drive, Suite A, Russell Springs, KY 42642 | 2009-10-11 |
| 1902079023 | Russell County Hospital | Specialist | 92 Jt Pettey Drive, Russell Springs, KY 42642 | 2008-04-09 |
| 1225242779 | Independent Speech Inc | Physical Therapist | 1831 Old Clear Springs Rd, Russell Springs, KY 42642 | 2007-05-10 |
| Find all providers in zip 42642 | ||||
| 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 |
|---|---|---|---|---|
| 1013979640 | Grider Drug LLC | Pharmacy | 2431b Lakeway Dr, Russell Springs, KY 42642-4510 | 2006-04-06 |
| 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 |
| 1376161588 | Arh Mary Breckinridge Health Services, Inc. | Pharmacy | 3504 West Cumberland Ave, Middlesboro, KY 40965-2612 | 2020-07-14 |
| 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 |
| Find all providers with the same taxonomy | ||||
| City | RUSSELL SPRINGS |
| Zip Code | 42642 |
Please comment or provide details below to improve the information on LAKE CUMBERLAND PHARMACY #2.
| 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.