Colemans Drugstore Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

P00253 Issued in KY

Legal business name

COLEMANS DRUGSTORE INC

Doing business as

Colemans Drug Store

Practice address

105 W Main St
Stanford, KY 40484-1253

Phone

(606) 365-2164

Fax

(606) 365-1181

NPI assigned

Aug 31, 2006

Last updated

Mar 1, 2017By 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

Alfred Pence

Title

President, Owner,Ao

Phone

(606) 365-2164

Specialties & licenses 4

Addresses

Other names 1

• COLEMANS DRUG STORE Doing business as

Medicare fee-for-service enrollment

Enrolled in KY2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Medicare medical equipment & supply locations

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.

• Crosby Grant Harris, PHARM D

  • Pharmacist
  • Stanford, KY
  • NPI 1912500380
  NPD (past)

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488326400000",
    "number": "1386756237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 W MAIN ST",
            "city": "STANFORD",
            "state": "KY",
            "postal_code": "404841253",
            "telephone_number": "606-365-2164",
            "fax_number": "606-365-1181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 W MAIN ST",
            "city": "STANFORD",
            "state": "KY",
            "postal_code": "404841253",
            "telephone_number": "606-365-2164",
            "fax_number": "606-365-1181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLEMANS DRUGSTORE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2017-03-01",
        "status": "A",
        "authorized_official_last_name": "PENCE",
        "authorized_official_first_name": "ALFRED",
        "authorized_official_title_or_position": "PRESIDENT, OWNER,AO",
        "authorized_official_telephone_number": "606-365-2164"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "KY",
            "license": "P00253",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "COLEMANS DRUG STORE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Haley Clark
• C. Glen Click, MD
• Shannah Click, APRN
• Allison Goble Cocanougher, OTD, OTR/L
• Teresa D Coffman, BS
• Andrew Wayne Cooper, DMD
• Alyssa Lee Ann Cornelius, APRN
• Charles Crase, MD
• Cumberland Family Medical Center Inc (Stanford Elementary Healthy Kids Clinic)
• Cumberland Family Medical Center Inc (Fort Logan Healthy Kids Clinic)

• Community/Retail Pharmacy in Stanford, KY
• Providers in Stanford, 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 Mar 1, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.

Verify at the official NPI Registry.