Organization Active NPI

Knox Professional Pharmacy Inc

  • Community/Retail Pharmacy
  • Barbourville, KY
National Provider Identifier
1003810490
Registry record updated Dec 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
P01088 Issued in KY
Legal business name
KNOX PROFESSIONAL PHARMACY INC
Practice address
511 Knox St
Barbourville, KY 40906-1330
Phone
(606) 546-3171
Fax
(606) 546-5022
NPI assigned
Jun 13, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
George Hammons, RPHNPI 1447254842
Title
Owner
Phone
(606) 546-3171

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X P01088 KY Primary

Addresses

Primary practice location

511 Knox St
Barbourville, KY 40906-1330

Mailing address

511 Knox St
Barbourville, KY 40906-1330
Phone (606) 546-3171

Other identifiers 3

IdentifierTypeStateIssuer
2029231OtherPK
7100176380MedicaidKY
7100176370MedicaidKY

Other names 1

  • KNOX PROFESSIONAL PHARMACY Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20051104000590 KY Part B Supplier - Mass Immunization (Roster Biller Only) 5092733303 Practice locations: Barbourville, KY
O20100930039120 KY DME Supplier - PharmacyDME Supplier - Medical Supply Company With Registered Pharmacist 5092733303 Practice locations: Barbourville, KY

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
18D1053556Knox Professional Pharmacy511 Knox Street, Barbourville, KY 40906Certificate of waiverApr 26, 2028

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Knox Professional Pharmacy Inc511 Knox St, Barbourville, KY 40906-1330(606) 546-3171 Immunosuppressive Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Commodes, Urinals, Bedpans|Blood Glucose Monitors/Supplies (Non-Mail Order)|Heat & Cold Applications|Canes and/or Crutches|Walkers|Wheelchairs (Standard Manual)|Wheelchairs (Standard Manual Related Accessories)|Whee… Accepts assignmentParticipating since Oct 1, 2005

National Provider Directory

National Provider Directory

Locations

511 Knox St
Barbourville, KY 40906
Phone (606) 546-3171

419 Knox St
Barbourville, KY 40906
Phone (606) 546-3171

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1118620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1480550400000",
    "number": "1003810490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "511 KNOX ST",
            "city": "BARBOURVILLE",
            "state": "KY",
            "postal_code": "409061330",
            "telephone_number": "606-546-3171",
            "fax_number": "606-546-5022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 KNOX ST",
            "city": "BARBOURVILLE",
            "state": "KY",
            "postal_code": "409061330",
            "telephone_number": "606-546-3171",
            "fax_number": "606-546-5022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KNOX PROFESSIONAL PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-13",
        "last_updated": "2016-12-01",
        "status": "A",
        "authorized_official_last_name": "HAMMONS",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "606-546-3171",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "KY",
            "license": "P01088",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2029231",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100176380",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100176370",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "KNOX PROFESSIONAL PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Barbourville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.