Crofton Pharmacy, LLC

Primary specialty

PharmacyTaxonomy code 333600000X

License

P07729 Issued in KY

Legal business name

CROFTON PHARMACY, LLC

Doing business as

Crofton Pharmacy

Practice address

110 E Main St
Crofton, KY 42217-8288

Phone

(270) 424-8965

Fax

(270) 424-8965

NPI assigned

Dec 7, 2015

Last updated

Dec 7, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Johnathan Fuller

Title

Owner

Phone

(270) 775-2771

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• CROFTON PHARMACY Doing business as

Tax ID family

Crofton Pharmacy2 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.

• Crofton Pharmacy LLC

  dba Crofton Pharmacy

  • Community/Retail Pharmacy
  • Crofton, KY
  • NPI 1063580066
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jeb Stewart, PHARMD

  • Pharmacist
  • Owensboro, KY
  • NPI 1407130164
  NPD

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

{
    "created_epoch": "1449446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1449446400000",
    "number": "1386019099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 126",
            "city": "BEAVER DAM",
            "state": "KY",
            "postal_code": "423200126",
            "telephone_number": "270-424-8965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 E MAIN ST",
            "city": "CROFTON",
            "state": "KY",
            "postal_code": "422178288",
            "telephone_number": "270-424-8965",
            "fax_number": "270-424-8965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROFTON PHARMACY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-07",
        "last_updated": "2015-12-07",
        "status": "A",
        "authorized_official_last_name": "FULLER",
        "authorized_official_first_name": "JOHNATHAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "270-775-2771"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "KY",
            "license": "P07729",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2155592",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "54017355",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CROFTON PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Commonwealth Biomedical Research, LLC
• Crofton Clinic PSC
• Crofton Dental Center PLLC
• Crofton Elementary School
• Crofton Pharmacy LLC (Crofton Pharmacy)
• Jerri Annette Fowler, SLP
• Marty E Gamble, DDS
• Jennie Stuart Medical Center Inc (Jennie Stuart Health Family Health Crofton RHC)
• Kirsten Myrick
• Angela D Pogue, APRN, FNP-C

• Pharmacy in Crofton, KY
• Providers in Crofton, KY by specialty
• Pharmacy in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2015; 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.