NPIMap

Organization Active NPI

Central State Hospital

  • Institutional Pharmacy
  • Louisville, KY
National Provider Identifier
1144467770
Registry record updated Apr 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Institutional PharmacyTaxonomy code 3336I0012X
License
P05065 Issued in KY
Legal business name
CENTRAL STATE HOSPITAL
Practice address
10510 La Grange Rd
Louisville, KY 40223-1277
Phone
(502) 253-7337
Fax
(502) 253-7344
NPI assigned
Jan 20, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2013

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

Authorized official

Name
Joe McCullen
Title
Senior Controller
Phone
(502) 253-7000

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic Pharmacy 3336C0002X
Institutional Pharmacy 3336I0012X P05065 KY Primary

Addresses

Primary practice location

10510 La Grange Rd
Louisville, KY 40223-1277

Mailing address

10510 La Grange Rd
Louisville, KY 40223-1277
Phone (502) 253-7337

Other identifiers 2

IdentifierTypeStateIssuer
54025408MedicaidKY
2118602OtherPK

Other names 1

  • CENTRAL STATE HOSPITAL PHARMACY Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Central State Hospital3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1232409600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1366588800000",
    "number": "1144467770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10510 LA GRANGE RD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402231277",
            "telephone_number": "502-253-7337",
            "fax_number": "502-253-7344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10510 LA GRANGE RD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402231277",
            "telephone_number": "502-253-7337",
            "fax_number": "502-253-7344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL STATE HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-20",
        "last_updated": "2013-04-22",
        "status": "A",
        "authorized_official_last_name": "MCCULLEN",
        "authorized_official_first_name": "JOE",
        "authorized_official_title_or_position": "SENIOR CONTROLLER",
        "authorized_official_telephone_number": "502-253-7000"
    },
    "taxonomies": [
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336I0012X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Institutional Pharmacy",
            "state": "KY",
            "license": "P05065",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "54025408",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2118602",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CENTRAL STATE HOSPITAL PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2013; 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.