Spencer Drug LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

P07752 Issued in KY

Legal business name

SPENCER DRUG LLC

Doing business as

Woodford Family Pharmacy

Practice address

453 Lexington Rd
Versailles, KY 40383-1646

Phone

(859) 879-3784

Fax

(859) 879-3882

NPI assigned

Feb 5, 2016

Organization subpart

No

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

Authorized official

Name

John Spencer

Title

Owner

Phone

(606) 434-3545

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Woodford Family Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in KY2 enrollments

Enrollment records 2

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Spencer Drug LLC

  • Community/Retail Pharmacy
  • Richmond, KY
  • NPI 1184973984

  9032319892

  Same PAC ID
• Spencer Drug LLC

  • Community/Retail Pharmacy
  • Irvine, KY
  • NPI 1316975923

  9032319892

  Same PAC ID
• Spencer Drug, LLC

  • Community/Retail Pharmacy
  • Irvine, KY
  • NPI 1851327290

  9032319892

  Same PAC ID

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Spencer Drug LLC

  • Community/Retail Pharmacy
  • Richmond, KY
  • NPI 1184973984

  O20110606000087

  Same enrollment
• Spencer Drug, LLC

  • Community/Retail Pharmacy
  • Irvine, KY
  • NPI 1851327290

  O20110606000087

  Same enrollment

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Tax ID family

Estill Clinic Pharmacy5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

• Spencer Drug LLC

  • Community/Retail Pharmacy
  • Richmond, KY
  • NPI 1184973984
  NPD tax ID
• Spencer Drug LLC

  • Long Term Care Pharmacy
  • Irvine, KY
  • NPI 1235975525
  NPD tax ID
• Spencer Drug LLC

  • Community/Retail Pharmacy
  • Irvine, KY
  • NPI 1316975923
  NPD tax ID
• Spencer Drug, LLC

  • Community/Retail Pharmacy
  • Irvine, KY
  • NPI 1851327290
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Paul L Mann, R.PH.

  • Pharmacist
  • Versailles, KY
  • NPI 1588955645
  NPD (past)

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

{
    "created_epoch": "1454630400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719187200000",
    "number": "1174981062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 943",
            "city": "VERSAILLES",
            "state": "KY",
            "postal_code": "403830943",
            "telephone_number": "859-879-3784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "453 LEXINGTON RD",
            "city": "VERSAILLES",
            "state": "KY",
            "postal_code": "403831646",
            "telephone_number": "859-879-3784",
            "fax_number": "859-879-3882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPENCER DRUG LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-05",
        "last_updated": "2024-06-24",
        "certification_date": "2024-06-24",
        "status": "A",
        "authorized_official_last_name": "SPENCER",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "606-434-3545"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "KY",
            "license": "P07752",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100396250",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2157928",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Woodford Family Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kimberly W Spalding, PT
• Michael S Spalding, PT
• Cindy Lee Spano, RN
• Angela Sparks, CNM
• Cynthia Renea Sparks, RN
• Dylan Spencer, PHARMD
• Kelley Sue Spencer, RPH
• St. Joseph Pharmacy, PLLC
• Kathleen McKendree Stanton
• Alexis Stepp, RBT

• Community/Retail Pharmacy in Versailles, KY
• Providers in Versailles, KY by specialty
• Community/Retail Pharmacy in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2024; 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.

Verify at the official NPI Registry.