Eastridge-Phelps Pharmacy

LBN: Eastridge-Phelps Pharmacy Llc
Eastridge-Phelps Pharmacy is an health care organization with primary practice located at 101 Winston Way Suite A, Campbellsville KY 42718-4953. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Eastridge-Phelps Pharmacy Llc can be contacted via phone (270) 789-0577, or through Phelps, Chad via phone (270) 789-0577.

Contact Information

Primary practice address
101 Winston Way Suite A Campbellsville KY 42718-4953
Phone: (270) 789-0577
Fax: (270) 789-0578
Website:
Map and Directions
Authorized official contact:
Name: Phelps, Chad
Phone: (270) 789-0577

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X
Suppliers / Community/Retail Pharmacy 3336C0003X P07325 Kentucky

Profile Details

NPI number 1245478007
LBN Legal business name Eastridge-Phelps Pharmacy Llc
DBA Doing business as Eastridge-Phelps Pharmacy
Authorized official Phelps, Chad
Entity Organization
Organization subpart 1 No
Enumeration date Jan 31st, 2009
Last updated Mar 5th, 2021 - about 5 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1245478007 NPPES
Other 1831038 NCPDP PROVIDER IDENTIFICATION NUMBER
MEDICAID 7100060880 NCPDP PROVIDER IDENTIFICATION NUMBER

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