Ely Special Pharmacy Inc.

Primary specialty

Specialty PharmacyTaxonomy code 3336S0011X

License

P07674 Issued in KY

Legal business name

ELY SPECIAL PHARMACY INC.

Practice address

4863C Scottsville Rd
Bowling Green, KY 42104-7909

Phone

(270) 467-5225

NPI assigned

Mar 18, 2015

Organization subpart

No

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

Authorized official

Name

Travis Hudnall

Title

Owner

Phone

(270) 467-5225

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Ely Specialty Pharmacy Doing business as

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

{
    "created_epoch": "1426636800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1426636800000",
    "number": "1710370580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4863C SCOTTSVILLE RD",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421047909",
            "telephone_number": "270-467-5225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4863C SCOTTSVILLE RD",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421047909",
            "telephone_number": "270-467-5225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELY SPECIAL PHARMACY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-18",
        "last_updated": "2015-03-18",
        "status": "A",
        "authorized_official_last_name": "HUDNALL",
        "authorized_official_first_name": "TRAVIS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "270-467-5225"
    },
    "taxonomies": [
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": "KY",
            "license": "P07674",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2150829",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ely Specialty Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jonathan David Ellis, BS, RBT
• Kimberly Renee Ellis, MT
• Olivia Kay Ellis
• Ely Drugs of BG Inc
• Ely Drugs of BG Inc
• Elydrugs of BG Inc.
• Tullio Emanuele, M.D.
• Dana Faye Emberton-Tinius, APRN
• Ashleigh Rashell Emberton, CSW
• Anne Embry, BHS

• Specialty Pharmacy in Bowling Green, KY
• Providers in Bowling Green, KY by specialty
• Specialty Pharmacy in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 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.