NPIMap

Organization Active NPI

Commonwealth of Kentucky

Doing business as Western State Hospital Pharmacy

  • Pharmacist
  • Hopkinsville, KY
National Provider Identifier
1124144456
Registry record updated Jul 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
Legal business name
COMMONWEALTH OF KENTUCKY
Doing business as
Western State Hospital Pharmacy
Practice address
2400 Russellville Road
Hopkinsville, KY 42240
Phone
(270) 889-6025
Fax
(270) 889-5062
NPI assigned
Mar 21, 2007
Last updated
Jul 8, 2015By the provider in NPPES
Organization subpart
Yes
Parent organization
COMMONWEALTH OF KENTUCKYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 8, 2015

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

Authorized official

Name
Stephanie Craycraft
Title
Director
Phone
(502) 782-6243

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X KY Primary
Psychiatric Pharmacist 1835P1300X KY
Long Term Care Pharmacy 3336L0003X P05010 KY
Long Term Care Pharmacy 3336L0003X P06561 KY
Geriatric Pharmacist 1835G0303X KY

Addresses

Primary practice location

2400 Russellville Road
Hopkinsville, KY 42240

Mailing address

2400 Russellville Road
Hopkinsville, KY 42240
Phone (270) 889-6025

Other identifiers 2

IdentifierTypeStateIssuer
54025598MedicaidKY
5402559800MedicaidKY

Other names 1

  • Western State Hospital Pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Commonwealth of Kentucky126 organizations share this tax ID, including this one
Part of
Commonwealth of Kentucky

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1436313600000",
    "number": "1124144456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 RUSSELLVILLE ROAD",
            "city": "HOPKINSVILLE",
            "state": "KY",
            "postal_code": "42240",
            "telephone_number": "270-889-6025",
            "fax_number": "270-889-5062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 RUSSELLVILLE ROAD",
            "city": "HOPKINSVILLE",
            "state": "KY",
            "postal_code": "42240",
            "telephone_number": "270-889-6025",
            "fax_number": "270-889-5062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMONWEALTH OF KENTUCKY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COMMONWEALTH OF KENTUCKY",
        "enumeration_date": "2007-03-21",
        "last_updated": "2015-07-08",
        "status": "A",
        "authorized_official_last_name": "CRAYCRAFT",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "502-782-6243"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "KY",
            "license": null,
            "primary": true
        },
        {
            "code": "1835P1300X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Psychiatric",
            "state": "KY",
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "KY",
            "license": "P05010",
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "KY",
            "license": "P06561",
            "primary": false
        },
        {
            "code": "1835G0303X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Geriatric",
            "state": "KY",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "54025598",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5402559800",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Western State Hospital Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hopkinsville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2015; 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.