Organization · Type 2 NPI

Lake Cumberland Pharmacy LLC

Community/Retail Pharmacy · Russell Springs, KY

NPI number 1912201906 Active

Practice location

124 Dowell Rd
Russell Springs, KY 42642-4278

Call (270) 866-2686 Map

Fax (270) 866-6566

Mailing address

PO Box 72
Russell Springs, KY 42642-0072

Specialties and licenses

Taxonomy	Code	License
Parenteral & Enteral Nutrition Supplies (DME)	332BP3500X	None listed
Pharmacy	333600000X	None listed
Community/Retail Pharmacy Primary	3336C0003X	P07440 (KY)

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 …

10 other providers at this address

Other community/retail pharmacy providers in Russell Springs

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NPI record

NPI: 1912201906
Entity type: Organization (Type 2)
Issued: Jan 5, 2011
Last updated: Oct 7, 2022
Status: Active

Other names

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Lake Cumberland Pharmacy #2 · doing business as
Lake Cumberland Pharmacy #2 · doing business as

Authorized official

Jonathan Grider, PharmD
Managing Member
(270) 858-6400

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 1912201906

Lake Cumberland Pharmacy LLC's National Provider Identifier is 1912201906, issued on Jan 5, 2011. The primary taxonomy on file is Community/Retail Pharmacy (3336C0003X), and the practice location is in Russell Springs, KY. The record was last updated on Oct 7, 2022.