Professional Center Pharmacy Annex

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PO6249 Issued in KY

Legal business name

PROFESSIONAL CENTER PHARMACY ANNEX

Practice address

793 Eastern by-Pass
Suite G-01
Richmond, KY 40475

Phone

(859) 623-8065

Fax

(859) 623-8065

NPI assigned

Oct 3, 2006

Last updated

Mar 7, 2023By 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

Mr. Larry F. Powell, R.PH.

Title

Owner

Phone

(859) 623-8065

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1699869651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "793 EASTERN BY-PASS",
            "address_2": "SUITE G-01",
            "city": "RICHMOND",
            "state": "KY",
            "postal_code": "40475",
            "telephone_number": "859-623-8065",
            "fax_number": "859-623-8065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "793 EASTERN BY-PASS",
            "address_2": "SUITE G-01",
            "city": "RICHMOND",
            "state": "KY",
            "postal_code": "40475",
            "telephone_number": "859-623-8065",
            "fax_number": "859-623-8065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL CENTER PHARMACY ANNEX",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "POWELL",
        "authorized_official_first_name": "LARRY",
        "authorized_official_middle_name": "F.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "859-623-8065",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "R.PH."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "KY",
            "license": "PO6249",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NABP",
            "identifier": "1824386",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "54031968",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Community/Retail Pharmacy in Richmond, KY
• Providers in Richmond, 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 Mar 7, 2023; 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.