Active NPI
Sam's
- Public Health or Welfare Agency
- Bowling Green, KY
National Provider Identifier
1225581820
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Public Health or Welfare Agency
- License
- 009538
- Legal business name
- SAM'S
- Practice address
- 3200 Ken Bale Blvd
Bowling Green, KY 42103-6025 - Phone
- (270) 781-7727
- Fax
- (270) 781-7826
- NPI assigned
- Jul 29, 2016
- 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
- Ms. Cathy Jones
- Title
- Pharmacist
- Phone
- (270) 842-7710
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Public Health or Welfare Agency | 251K00000X | 009538 | KY | Primary |
Addresses
Primary practice location
3200 Ken Bale Blvd
Bowling Green, KY 42103-6025
Mailing address
3111 Smallhouse Rd
Bowling Green, KY 42104-4603
Phone (270) 781-7727
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 |
|---|---|---|---|
| 18D2126788 | Sam's Club Pharmacy 10-4876 | Certificate of waiver | Mar 5, 2027 |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Pharmacist
- Bowling Green, KY
- NPI 1902359318
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1469750400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1469750400000",
"number": "1225581820",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3111 SMALLHOUSE RD",
"city": "BOWLING GREEN",
"state": "KY",
"postal_code": "421044603",
"telephone_number": "270-781-7727",
"fax_number": "270-781-7826"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3200 KEN BALE BLVD",
"city": "BOWLING GREEN",
"state": "KY",
"postal_code": "421036025",
"telephone_number": "270-781-7727",
"fax_number": "270-781-7826"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SAM'S",
"organizational_subpart": "NO",
"enumeration_date": "2016-07-29",
"last_updated": "2016-07-29",
"status": "A",
"authorized_official_last_name": "JONES",
"authorized_official_first_name": "CATHY",
"authorized_official_title_or_position": "PHARMACIST",
"authorized_official_telephone_number": "270-842-7710",
"authorized_official_name_prefix": "Ms."
},
"taxonomies": [
{
"code": "251K00000X",
"taxonomy_group": "",
"desc": "Public Health or Welfare",
"state": "KY",
"license": "009538",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Bowling Green, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- 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.