Active NPI
C & G Pharmacy LLC.
Doing business as Crume Drug Store
- Community/Retail Pharmacy
- Bardstown, KY
National Provider Identifier
1174083406
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- Legal business name
- C & G PHARMACY LLC.
- Doing business as
- Crume Drug Store
- Practice address
- 111 W Flaget St
Bardstown, KY 40004-1422 - Phone
- (502) 348-3938
- NPI assigned
- Mar 22, 2019
- Last updated
- Aug 27, 2019
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. E. Ashley Coomes, CPHT
- Title
- Owner
- Phone
- (502) 348-3938
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | NU | Primary |
Addresses
Primary practice location
111 W Flaget St
Bardstown, KY 40004-1422
Mailing address
111 W Flaget St
Bardstown, KY 40004-1422
Phone (502) 348-3938
Other names 1
- Crume Drug Store
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KY
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20191028001774 | KY | Part B Supplier - Pharmacy | 7012249873 | Practice locations: Bardstown, KY |
| O20200115003235 | KY | DME Supplier - Pharmacy | 7012249873 | Practice locations: Bardstown, KY |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 18D2344650 | C&G Pharmacy LLC | Certificate of waiver | May 26, 2028 |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
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.
-
- Pharmacy Technician
- Bardstown, KY
- NPI 1821681719
-
- Pharmacist
- Louisville, KY
- NPI 1295016509
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1553212800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1566864000000",
"number": "1174083406",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "111 W FLAGET ST",
"city": "BARDSTOWN",
"state": "KY",
"postal_code": "400041422",
"telephone_number": "502-348-3938"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 W FLAGET ST",
"city": "BARDSTOWN",
"state": "KY",
"postal_code": "400041422",
"telephone_number": "502-348-3938"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "C & G PHARMACY LLC.",
"organizational_subpart": "NO",
"enumeration_date": "2019-03-22",
"last_updated": "2019-08-27",
"status": "A",
"authorized_official_last_name": "COOMES",
"authorized_official_first_name": "E.",
"authorized_official_middle_name": "ASHLEY",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "502-348-3938",
"authorized_official_name_prefix": "Mrs.",
"authorized_official_credential": "CPHT"
},
"taxonomies": [
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Crume Drug Store",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Crume Drug Store",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Bardstown, KY
- Jaden Grace Burba
- Burgett, PSC (Bardstown Chiropractic Pain & Injury Center)
- Eric Thomas Burkard, MA, ATC,CSCS
- Lindsey Byrd
- Legrande Richard Byrnes, DPT
- Mark Alan Cain, LCSW
- Cardiac Care Center of Louisville, PLLC (Medical Center Cardiologists)
- Diane M Cardin, ARNP
- Kelli Rose Carney, RBT
- Kimberly Slone Carolan, MS OTR/L
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.