Organization Active NPI

DSSK Pharmaceuticals

Doing business as The Medicine Shoppe 1479

  • Pharmacist
  • Hazard, KY
National Provider Identifier
1205834314
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
6469 Issued in KY
Legal business name
DSSK PHARMACEUTICALS
Doing business as
The Medicine Shoppe 1479
Practice address
145 Citizens LN
Suite a
Hazard, KY 41701-1352
Phone
(606) 435-2020
Fax
(606) 487-8172
NPI assigned
Jul 12, 2005
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Donald R Fields, R PH
Title
Owner/Chief Pharmacist
Phone
(606) 435-2020

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 6469 KY Primary

Addresses

Primary practice location

145 Citizens LN
Suite a
Hazard, KY 41701-1352

Mailing address

145 Citizens LN
Suite a
Hazard, KY 41701-1352
Phone (606) 435-2020

Other identifiers 1

IdentifierTypeStateIssuer
54032271MedicaidKY

Other names 1

  • The Medicine Shoppe 1479 Doing business as

National Provider Directory

National Provider Directory

Locations

145 Citizens Ln
Ste A
Hazard, KY 41701
Phone (606) 435-2020

NPI Registry JSON

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

{
    "created_epoch": "1121126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1205834314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 CITIZENS LN",
            "address_2": "SUITE A",
            "city": "HAZARD",
            "state": "KY",
            "postal_code": "417011352",
            "telephone_number": "606-435-2020",
            "fax_number": "606-487-8172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 CITIZENS LN",
            "address_2": "SUITE A",
            "city": "HAZARD",
            "state": "KY",
            "postal_code": "417011352",
            "telephone_number": "606-435-2020",
            "fax_number": "606-487-8172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DSSK PHARMACEUTICALS",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FIELDS",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER/CHIEF PHARMACIST",
        "authorized_official_telephone_number": "606-435-2020",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "R PH"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "KY",
            "license": "6469",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "54032271",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Medicine Shoppe 1479",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hazard, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.