Georgetown Apothecary PLLC

Key facts

NPI

1407291982

Entity type

Organization (NPI type 2)

Primary specialty

Community/Retail Pharmacy 3336C0003X

License

P07573 (KY)

Legal business name

GEORGETOWN APOTHECARY PLLC

Practice address

1002 S Broadway St Ste 7
Georgetown, KY 40324-1463

Phone

(502) 370-4336

Fax

(502) 370-4352

NPI assigned

May 9, 2013

Organization subpart

No

Authorized official

Name

Justin Bell, RPH

Title

Owner

Phone

(502) 370-4336

National Provider Directory

Specialties & licenses

Addresses

Other identifiers

Other names

• Georgetown Pharmacy Doing business as

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Feb 14, 2017.

{
    "created_epoch": "1368057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487030400000",
    "number": "1407291982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1002 S BROADWAY ST STE 7",
            "city": "GEORGETOWN",
            "state": "KY",
            "postal_code": "403241463",
            "telephone_number": "502-370-4336",
            "fax_number": "502-370-4352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1002 S BROADWAY ST STE 7",
            "city": "GEORGETOWN",
            "state": "KY",
            "postal_code": "403241463",
            "telephone_number": "502-370-4336",
            "fax_number": "502-370-4352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGETOWN APOTHECARY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-09",
        "last_updated": "2017-02-14",
        "status": "A",
        "authorized_official_last_name": "BELL",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "502-370-4336",
        "authorized_official_credential": "RPH"
    },
    "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": "P07573",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100245800",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2140326",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Georgetown Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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