Southall Pharmacy PLLC
Organization Active NPI Durable Medical Equipment & Medical Supplies · Lebanon, KY
NPI 1497871859 · NPPES record last updated Mar 2, 2009
Key facts
- NPI
- 1497871859
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Durable Medical Equipment & Medical Supplies 332B00000X
- License
- P02451 (KY)
- Legal business name
- SOUTHALL PHARMACY PLLC
- Practice address
- 325 W Walnut St
Suite 500
Lebanon, KY 40033-1377 - Phone
- (270) 692-3111
- Fax
- (270) 692-4211
- NPI assigned
- Mar 21, 2007
- Organization subpart
- No
Authorized official
- Name
- Mr. Francis W Southall Jr., RPH
- Title
- Owner
- Phone
- (270) 692-3111
Corporate family (same tax ID) 3
National Provider Directory
- Tax ID family
- Francis W Southall Jr
Locations
325 W Walnut St
Ste 500
Lebanon, KY 40033
Phone (270) 692-3111
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | P02451 | KY | Yes |
| Dialysis Equipment & Supplies (DME) | 332BD1200X | P02451 | KY | |
| Nursing Facility Supplies (DME) | 332BN1400X | P02451 | KY | |
| Parenteral & Enteral Nutrition Supplies (DME) | 332BP3500X | P02451 | KY | |
| Oxygen Equipment & Supplies (DME) | 332BX2000X | P02451 | KY |
Addresses
Primary practice location
325 W Walnut St
Suite 500
Lebanon, KY 40033-1377
Mailing address
325 W Walnut St
Suite 500
Lebanon, KY 40033-1377
Phone (270) 692-3111
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 90040783 | Medicaid | KY |
Other providers in Lebanon, KY
- Sarah Smith
- Stacy L Smithson
- Heather Michelle Smothers
- Southall Family Pharmacy
- Southall Pharmacy PLLC
- Abigail Hagan Southall
- Francis W Southall, Jr
- Michael Southall
- Stefanie Kaye Spalding
- Spring View Hospital LLC
All providers in Lebanon, KY · Durable Medical Equipment & Medical Supplies in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 2, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.