Main Street Pharmacy

LBN: Main Street Pharmacy Llc
Main Street Pharmacy is an health care organization with primary practice located at 150 Main Street Pharmacy , Mt Vernon KY 40456. 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. Main Street Pharmacy Llc can be contacted via phone (606) 256-0475, or through Gibbs, Eric via phone (606) 258-0000.

Contact Information

Primary practice address
150 Main Street Pharmacy Mt Vernon KY 40456
Phone: (606) 256-0475
Fax: (606) 256-0421
Website:
Map and Directions
Authorized official contact:
Name: Gibbs, Eric
Phone: (606) 258-0000

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X
Suppliers / Community/Retail Pharmacy 3336C0003X P07220 Kentucky

Profile Details

NPI number 1669652210
LBN Legal business name Main Street Pharmacy Llc
DBA Doing business as Main Street Pharmacy
Authorized official Gibbs, Eric
Entity Organization
Organization subpart 1 No
Enumeration date Nov 13th, 2007
Last updated Aug 25th, 2011 - about 15 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 1669652210 NPPES
Kentucky MEDICAID 7100037810
Kentucky Other 1830416
Kentucky MEDICAID 7100014800

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