Advance Care Pharmacy PLLC
Organization Active NPI Community/Retail Pharmacy · Somerset, KY
NPI 1104409564 · NPPES record last updated Nov 15, 2024
Key facts
- NPI
- 1104409564
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- Legal business name
- ADVANCE CARE PHARMACY PLLC
- Practice address
- 25 Medpark Square Dr Ste 4
Somerset, KY 42503-1708 - Phone
- (606) 676-0199
- Fax
- (606) 451-7727
- NPI assigned
- May 4, 2021
- Organization subpart
- No
Authorized official
- Name
- Dr. Jody Dungan, PHARM.D.
- Title
- Pharmacist in Charge
- Phone
- (606) 676-0199
Practitioners 2
-
Weston Dungan, PHARM.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KY
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20210924003062 | KY | Part B Supplier - Mass Immunization (Roster Biller Only) | 0547667099 | Practice locations: Somerset, KY |
National Provider Directory
Locations
25 Medpark Square Dr
Ste 4
Somerset, KY 42503
Phone (205) 412-3863
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | Yes | ||
| Compounding Pharmacy | 3336C0004X |
Addresses
Primary practice location
25 Medpark Square Dr Ste 4
Somerset, KY 42503-1708
Mailing address
25 Medpark Square Dr Ste 4
Somerset, KY 42503-1708
Phone (606) 676-0199
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7100753830 | Medicaid | KY |
Other names
- Advance Care Pharmacy
Other providers in Somerset, KY
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- Adult Day Health, Inc.
- Adult Day Health, Inc.
- Advance Care Pharmacy PLLC
- Advanced Family Medical Clinic Mount Vernon
- Advantagepoint Health Alliance - Bluegrass, LLC
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- Aegis Mental Health
All providers in Somerset, KY · Community/Retail Pharmacy in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 15, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.