Professional Pharmacy, LLC

Primary specialty

PharmacyTaxonomy code 333600000X

License

6797 Issued in KY

Legal business name

PROFESSIONAL PHARMACY, LLC

Practice address

342 Bogle St
Suite 3
Somerset, KY 42503-2851

Phone

(606) 679-7979

Fax

(606) 678-0370

NPI assigned

Oct 5, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Dan Slusher, RPH

Title

Pharmacist Owner

Phone

(606) 679-1169

Specialties & licenses 2

Addresses

Other identifiers 3

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Medicare medical equipment & supply locations

Locations

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

{
    "created_epoch": "1128470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210550400000",
    "number": "1700873544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "342 BOGLE ST",
            "address_2": "SUITE 3",
            "city": "SOMERSET",
            "state": "KY",
            "postal_code": "425032851",
            "telephone_number": "606-679-1169",
            "fax_number": "606-679-1049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "342 BOGLE ST",
            "address_2": "SUITE 3",
            "city": "SOMERSET",
            "state": "KY",
            "postal_code": "425032851",
            "telephone_number": "606-679-7979",
            "fax_number": "606-678-0370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL PHARMACY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-05",
        "last_updated": "2008-05-12",
        "status": "A",
        "authorized_official_last_name": "SLUSHER",
        "authorized_official_first_name": "DAN",
        "authorized_official_title_or_position": "PHARMACIST OWNER",
        "authorized_official_telephone_number": "606-679-1169",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "KY",
            "license": "6797",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PROVIDER NUMBER",
            "identifier": "000000245485",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "54004221",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "90005240",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.