Middletown Pharmacist Group

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

MIDDLETOWN PHARMACIST GROUP

Practice address

11601 Shelbyville Rd Ste a
Louisville, KY 40243-1309

Phone

(502) 690-2410

Fax

(502) 690-2219

NPI assigned

Oct 21, 2020

Organization subpart

No

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

Authorized official

Name

Sherry Stevens, CPHT

Title

Cro

Phone

(502) 690-2410

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Middletown Pharmacy & Wellness Doing business as

Medicare fee-for-service enrollment

Enrolled in KY2 enrollments

Enrollment records 2

Tax ID family

Middletown Pharmacist Group2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Middletown Pharmacist Group

  • Long Term Care Pharmacy
  • Louisville, KY
  • NPI 1164151585
  NPD tax ID

Locations

Practitioners 4

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

• Mary Burgess, PHARMD

  • Pharmacist
  • Louisville, KY
  • NPI 1487109666
  NPD
• Nancy E Deines, R.PH.

  • Pharmacist
  • Louisville, KY
  • NPI 1336515352
  NPD
• Danielle Moorman, PHARMD, MBA

  • Pharmacist
  • Louisville, KY
  • NPI 1255178893
  NPD
• Tara Ann Schneider, PHARM.D.

  • Pharmacist
  • Oklahoma City, OK
  • NPI 1811527294
  NPD

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

{
    "created_epoch": "1603238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1637539200000",
    "number": "1306445259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 FOXGLOVE DR STE A",
            "city": "MOUNT STERLING",
            "state": "KY",
            "postal_code": "403539735",
            "telephone_number": "502-690-2410",
            "fax_number": "502-690-2219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11601 SHELBYVILLE RD STE A",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402431309",
            "telephone_number": "502-690-2410",
            "fax_number": "502-690-2219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDDLETOWN PHARMACIST GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-21",
        "last_updated": "2021-11-22",
        "certification_date": "2021-11-22",
        "status": "A",
        "authorized_official_last_name": "STEVENS",
        "authorized_official_first_name": "SHERRY",
        "authorized_official_title_or_position": "CRO",
        "authorized_official_telephone_number": "502-690-2410",
        "authorized_official_credential": "CPHT"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100717140",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Middletown Pharmacy & Wellness",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Middletown Pharmacy & Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Middletown Eye Physicians, PLC
• Middletown Medical Group
• Middletown Opticians LLC
• Middletown Pediatrics
• Middletown Pharmacist Group
• Eric Midenberg, MD
• Midstream Home Urological
• Midwest Anesthesia Services LLC
• Midwest Gastroenterology Associates
• Midwest Geriatrics

• Community/Retail Pharmacy in Louisville, KY
• Providers in Louisville, 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 Nov 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.