Organization Active NPI

Home Convalescent AIDS, Inc.

  • Community/Retail Pharmacy
  • Winchester, KY
National Provider Identifier
1104807841
Registry record updated Apr 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
P01493 Issued in KY
Legal business name
HOME CONVALESCENT AIDS, INC.
Practice address
1113 W Lexington Ave
Winchester, KY 40391-1169
Phone
(859) 745-4445
Fax
(859) 745-0483
NPI assigned
Nov 9, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2008

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

Authorized official

Name
Mr. Donald Kenneth Dove, RPH
Title
President/Pharmacist
Phone
(859) 745-4445

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Community/Retail Pharmacy 3336C0003X P01493 KY Primary

Addresses

Primary practice location

1113 W Lexington Ave
Winchester, KY 40391-1169

Mailing address

1113 W Lexington Ave
Winchester, KY 40391-1169
Phone (859) 745-4445

Other identifiers 1

IdentifierTypeStateIssuer
90030255MedicaidKY

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1131494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207785600000",
    "number": "1104807841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1113 W LEXINGTON AVE",
            "city": "WINCHESTER",
            "state": "KY",
            "postal_code": "403911169",
            "telephone_number": "859-745-4445",
            "fax_number": "859-745-0483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1113 W LEXINGTON AVE",
            "city": "WINCHESTER",
            "state": "KY",
            "postal_code": "403911169",
            "telephone_number": "859-745-4445",
            "fax_number": "859-745-0483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOME CONVALESCENT AIDS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-09",
        "last_updated": "2008-04-10",
        "status": "A",
        "authorized_official_last_name": "DOVE",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "KENNETH",
        "authorized_official_title_or_position": "PRESIDENT/PHARMACIST",
        "authorized_official_telephone_number": "859-745-4445",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "KY",
            "license": "P01493",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "90030255",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winchester, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2008; 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.