Claywell Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

P01371 Issued in KY

Legal business name

CLAYWELL INC

Doing business as

Medica Pharmacy & Wellness Center

Practice address

202 W Stephen Foster Ave
Bardstown, KY 40004-1478

Phone

(502) 348-6623

Fax

(502) 348-7704

NPI assigned

Jul 16, 2006

Last updated

Nov 29, 2021By 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

Alyson Roby, RPH

Title

Pres/Ceo

Phone

(502) 348-6623

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• MEDICA PHARMACY & WELLNESS CENTER Doing business as

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Claywell, Inc

  dba Medica Pharmacy

  • Community/Retail Pharmacy
  • Springfield, KY
  • NPI 1780139949

  9931147618

  Same PAC ID

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

{
    "created_epoch": "1153008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638144000000",
    "number": "1407873235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 W STEPHEN FOSTER AVE",
            "city": "BARDSTOWN",
            "state": "KY",
            "postal_code": "400041478",
            "telephone_number": "502-348-6623",
            "fax_number": "502-348-7704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 W STEPHEN FOSTER AVE",
            "city": "BARDSTOWN",
            "state": "KY",
            "postal_code": "400041478",
            "telephone_number": "502-348-6623",
            "fax_number": "502-348-7704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLAYWELL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-16",
        "last_updated": "2021-11-29",
        "certification_date": "2021-11-29",
        "status": "A",
        "authorized_official_last_name": "ROBY",
        "authorized_official_first_name": "ALYSON",
        "authorized_official_title_or_position": "PRES/CEO",
        "authorized_official_telephone_number": "502-348-6623",
        "authorized_official_credential": "RPH"
    },
    "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": "P01371",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "54000302",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "90006909",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MEDICA PHARMACY & WELLNESS CENTER",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MEDICA PHARMACY & WELLNESS CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Central Kentucky Pharmacy Inc (Crume Drug Store)
• Stacey Loraine Chevalier, IECE, HI
• Chiropractic Health Center of Bardstown PLLC
• Choice Rehab Inc
• Claywell Inc (Medica Pharmacy & Wellness Center)
• J Leon Claywell, R.PH.
• Jay Ryan Claywell, D.M.D.
• Melanie M Clements, OTRL
• Cassady Cobb
• Molly Elisabeth Cockerel

• Community/Retail Pharmacy in Bardstown, KY
• Providers in Bardstown, 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 Nov 29, 2021; 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.