Southeastern Family Drug Center, Inc

Primary specialty

PharmacyTaxonomy code 333600000X

License

P01555 Issued in KY

Legal business name

SOUTHEASTERN FAMILY DRUG CENTER, INC

Doing business as

Family Drug Center 3

Practice address

214 Bridge St
Manchester, KY 40962-1204

Phone

(606) 598-6736

Fax

(606) 599-0636

NPI assigned

Dec 12, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Robert P Sparkman, R.PH.

Title

Secretary

Phone

(606) 598-6736

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Family Drug Center 3 Doing business as

Locations

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1425427200000",
    "number": "1619037181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "214 BRIDGE ST",
            "city": "MANCHESTER",
            "state": "KY",
            "postal_code": "409621204",
            "telephone_number": "606-598-6736",
            "fax_number": "606-599-0636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 BRIDGE ST",
            "city": "MANCHESTER",
            "state": "KY",
            "postal_code": "409621204",
            "telephone_number": "606-598-6736",
            "fax_number": "606-599-0636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEASTERN FAMILY DRUG CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-12",
        "last_updated": "2015-03-04",
        "status": "A",
        "authorized_official_last_name": "SPARKMAN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "606-598-6736",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "R.PH."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "KY",
            "license": "P01555",
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "KY",
            "license": "P01555",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5401807200",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "90070269",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Drug Center 3",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sherri Larae Smith, APRN
• Suzann Smith, APRN
• Tara Lee Smith, APRN
• Tonya Smith, PT
• Smith's Hometown Family Practice, LLC
• Southeastern Family Drug Center, Inc (Family Drug Center)
• Southeastern Medical Supply LLC
• Amber Sowders, OTR/L
• Dinah Lynn Sowders, SLP
• Star Bright, LLC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 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.