Salem Clinic Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

P06918 Issued in KY

Legal business name

SALEM CLINIC PHARMACY INC

Doing business as

Clinic Pharmacy of Ky

Practice address

141 Hospital Dr
Salem, KY 42078-8043

Phone

(270) 988-3230

Fax

(270) 988-4230

NPI assigned

Oct 2, 2006

Last updated

Sep 4, 2015By 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

Michael Keller, RPHNPI 1730275892

Title

Owner,Pic,Ao

Phone

(270) 988-3230

Specialties & licenses 4

Addresses

Other identifiers 5

Other names 1

• CLINIC PHARMACY OF KY 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.

Medicare medical equipment & supply locations

Practitioners 2

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.

• Michael L Keller, R.PH., PHARM.D.

  • Pharmacist
  • Salem, KY
  • NPI 1730275892
  Authorized official Same address or phone
• Lee Ann Grainger Keller, ARNP, RN

  • Psychiatric/Mental Health Nurse Practitioner
  • Salem, KY
  • NPI 1700191228
  NPD (past)

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1441324800000",
    "number": "1669566170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 498",
            "city": "SALEM",
            "state": "KY",
            "postal_code": "420780498",
            "telephone_number": "270-988-3230",
            "fax_number": "270-988-4230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 HOSPITAL DR",
            "city": "SALEM",
            "state": "KY",
            "postal_code": "420788043",
            "telephone_number": "270-988-3230",
            "fax_number": "270-988-4230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SALEM CLINIC PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-02",
        "last_updated": "2015-09-04",
        "status": "A",
        "authorized_official_last_name": "KELLER",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER,PIC,AO",
        "authorized_official_telephone_number": "270-988-3230",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "KY",
            "license": "P06918",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9001070300",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100171870",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2029123",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4554139800",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "54017165",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CLINIC PHARMACY OF KY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Codie L Parks, PHARMD
• Demetrius L Patton, M.D.
• Kara Ann Phillips, APRN
• Linn Phillips, ARNP
• R V Bharne PSC
• Salem Health Care Group LLC
• Kristee Croft Shoulders, APRN
• Tri-Rivers Healthcare PLLC (Salem Medical Clinic)
• Tri-Rivers Healthcare, PLLC (TRHC Hospital Services)
• Misty Jones Turmero, PHARM D

• Community/Retail Pharmacy in Salem, KY
• Providers in Salem, 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 Sep 4, 2015; 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.