Stultz Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

P01316 Issued in KY

Legal business name

STULTZ PHARMACY INC

Doing business as

STULTZ PHARMACY

Practice address

1615 Ashland Rd
Greenup, KY 41144-1207

Phone

(606) 473-7346

Fax

(606) 473-5667

NPI assigned

Jul 6, 2006

Organization subpart

No

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

Authorized official

Name

Brad Stultz

Title

Owner

Phone

(606) 473-7346

Specialties & licenses 4

Addresses

Other identifiers 6

Other names 1

• STULTZ PHARMACY Doing business as

Locations

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1492041600000",
    "number": "1225069487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1615 ASHLAND RD",
            "city": "GREENUP",
            "state": "KY",
            "postal_code": "411441207",
            "telephone_number": "606-473-7346",
            "fax_number": "606-473-5667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1615 ASHLAND RD",
            "city": "GREENUP",
            "state": "KY",
            "postal_code": "411441207",
            "telephone_number": "606-473-7346",
            "fax_number": "606-473-5667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STULTZ PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-06",
        "last_updated": "2017-04-13",
        "status": "A",
        "authorized_official_last_name": "STULTZ",
        "authorized_official_first_name": "BRAD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "606-473-7346"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "KY",
            "license": "P01316",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2418341",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100196620",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "90020454",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100198150",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2029486",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "54016134",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "STULTZ PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Derica Stake, LPN
• Melissa Stewart, PSS
• Christen Stiltner
• Brittany Stone, LPCC
• Stultz Home Medical Supplies Inc
• Stultz Pharmacy Inc
• Brad Stultz
• Darrell Terry
• Charles Brandon Thomas
• Linda Timberlake

• Community/Retail Pharmacy in Greenup, KY
• Providers in Greenup, 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 Apr 13, 2017; 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.