McDonald Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

P01070 Issued in KY

Legal business name

MCDONALD PHARMACY INC

Doing business as

McDonald Pharmacy

Practice address

437 James E Hannah Dr
South Shore, KY 41175-9600

Phone

(606) 932-3614

Fax

(606) 932-3614

NPI assigned

Nov 7, 2006

Last updated

Jul 26, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

David Bradley Stultz, RPH

Title

Pic

Phone

(606) 922-5512

Specialties & licenses 3

Addresses

Other identifiers 3

Other names 1

• MCDONALD PHARMACY Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Timothy Wyatt Quillen

  • Pharmacist
  • South Shore, KY
  • NPI 1093412025
  NPD (past)
• Dora Jo Williams

  • Pharmacist
  • South Shore, KY
  • NPI 1144788498
  NPD (past)

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627257600000",
    "number": "1073682852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 774",
            "city": "SOUTH SHORE",
            "state": "KY",
            "postal_code": "411750774",
            "telephone_number": "606-932-3614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "437 JAMES E HANNAH DR",
            "city": "SOUTH SHORE",
            "state": "KY",
            "postal_code": "411759600",
            "telephone_number": "606-932-3614",
            "fax_number": "606-932-3614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCDONALD PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-07",
        "last_updated": "2021-07-26",
        "certification_date": "2021-07-26",
        "status": "A",
        "authorized_official_last_name": "STULTZ",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "BRADLEY",
        "authorized_official_title_or_position": "PIC",
        "authorized_official_telephone_number": "606-922-5512",
        "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": "P01070",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0391517",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2029133",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "54014196",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MCDONALD PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MCDONALD PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jerry Wayne Iery, PA
• Joseph Dental of South Shore LLC (South Shore Family Dental)
• Lewis County Primary Care Center, Inc. (South Shore Family Health Center Pharmacy)
• Lewis County Primary Care Center, Inc. (PrimaryPlus)
• Little Leaps Therapy Co.
• Sarah Martin Meadows, LPN
• Forrest Elmer Monoskie, DC
• Karen Sue Morrow I, STNA
• Mountain Comprehensive Care Center, Inc. (Christ Care Pediatrics)
• Jessica Paige Mullins, HOME HEALTH AIDE

• Community/Retail Pharmacy in South Shore, KY
• Providers in South Shore, KY by specialty
• Community/Retail Pharmacy in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.