Organization · Type 2 NPI

Commonwealth of Kentucky

Pharmacist · Hopkinsville, KY

NPI number 1124144456 Active

Practice location

2400 Russellville Road
Hopkinsville, KY 42240

Fax (270) 889-5062

Specialties and licenses

Taxonomy	Code	License
Pharmacist Primary	183500000X	None listed
Geriatric Pharmacist	1835G0303X	None listed
Psychiatric Pharmacist	1835P1300X	None listed
Long Term Care Pharmacy	3336L0003X	P05010 (KY)
Long Term Care Pharmacy	3336L0003X	P06561 (KY)

Pharmacist: An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage…

NPI record

NPI: 1124144456
Entity type: Organization (Type 2)
Issued: Mar 21, 2007
Last updated: Jul 8, 2015
Status: Active
Subpart: Yes of Commonwealth of Kentucky

Other names

<unavail>
Western State Hospital Pharmacy · doing business as

Authorized official

Stephanie Craycraft
Director
(502) 782-6243

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1124144456

Commonwealth of Kentucky's National Provider Identifier is 1124144456, issued on Mar 21, 2007. The primary taxonomy on file is Pharmacist (183500000X), and the practice location is in Hopkinsville, KY. The record was last updated on Jul 8, 2015.