Windham Drug Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

P07247 Issued in KY

Legal business name

WINDHAM DRUG INC

Doing business as

WINDHAM DRUG

Practice address

1605 S Highway 25 W
Williamsburg, KY 40769-1610

Phone

(606) 549-3636

Fax

(606) 549-9155

NPI assigned

Apr 8, 2008

Organization subpart

No

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

Authorized official

Name

Justin Smith, PHARMDNPI 1013769108

Title

Vice-President

Phone

(606) 549-3636

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• WINDHAM DRUG Doing business as

Medicare fee-for-service enrollment

Enrolled in KY2 enrollments

Enrollment records 2

Tax ID family

Windham Drug2 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.

• Windham Drug Inc

  • Long Term Care Pharmacy
  • Williamsburg, KY
  • NPI 1942021548
  NPD tax ID

Locations

Practitioners 2

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

• Justin Smith, PHARMD

  • Pharmacist
  • Williamsburg, KY
  • NPI 1013769108
  NPD (past) Authorized official
• Warren Brooks Gardner, PHARM.D.

  • Pharmacist
  • Williamsburg, KY
  • NPI 1558544403
  NPD (past)

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

{
    "created_epoch": "1207612800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1452124800000",
    "number": "1356514632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1605 S HIGHWAY 25 W",
            "city": "WILLIAMSBURG",
            "state": "KY",
            "postal_code": "407691610",
            "telephone_number": "606-549-3636",
            "fax_number": "606-549-9155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1605 S HIGHWAY 25 W",
            "city": "WILLIAMSBURG",
            "state": "KY",
            "postal_code": "407691610",
            "telephone_number": "606-549-3636",
            "fax_number": "606-549-9155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WINDHAM DRUG INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-08",
        "last_updated": "2016-01-07",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_title_or_position": "VICE-PRESIDENT",
        "authorized_official_telephone_number": "606-549-3636",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "KY",
            "license": "P07247",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2035127",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100037700",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WINDHAM DRUG",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Williamsburg Nursing Home, Inc.
• Williamsburg Pharmacy
• Williamsburg Pharmacy Inc
• Kelli Leigh Williamson, M.S., CF-SLP
• Dylan Lee Wilson, PT,DPT
• Windham Drug Inc
• Windham Drug North, Inc
• Jessielene Wright, APRN
• Heidi Marie Zwick, ATC

• Community/Retail Pharmacy in Williamsburg, KY
• Providers in Williamsburg, 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 Jan 7, 2016; 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.