Wayne D. Sparrow

Individual provider Active NPI Pharmacist · Eminence, KY

NPI 1376148197 · NPPES record last updated Dec 1, 2020

Key facts

NPI
1376148197
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist 183500000X
License
008128 (KY)
Practice address
4894 N Main St
Eminence, KY 40019-1018
Phone
(502) 845-5027
Fax
(502) 845-5077
NPI assigned
Dec 1, 2020
Sex
Male
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
008128KYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Kentucky CVS Pharmacy LLC Past
since Dec 6, 2020
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 008128 KY Yes

Addresses

Primary practice location

4894 N Main St
Eminence, KY 40019-1018

Mailing address

4894 N Main St
Eminence, KY 40019-1018
Phone (502) 845-5027

Other providers in Eminence, KY

All providers in Eminence, KY · Pharmacist in Kentucky

Sources for this page

Verify at the official NPI Registry.