Larry J & Bonnie P Russell

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

LARRY J & BONNIE P RUSSELL

Doing business as

The Medicine Shoppe

Practice address

910 N Dixie Ave Ste 105
Elizabethtown, KY 42701-2519

Phone

(270) 769-3717

Fax

(270) 769-2887

NPI assigned

Oct 25, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Larry Russell, R.PH.

Title

Owner

Phone

(270) 769-3717

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• The Medicine Shoppe Doing business as

Locations

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

{
    "created_epoch": "1130198400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1710977442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "910 N DIXIE AVE STE 105",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427012519",
            "telephone_number": "270-769-3717",
            "fax_number": "270-769-2887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 N DIXIE AVE STE 105",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427012519",
            "telephone_number": "270-769-3717",
            "fax_number": "270-769-2887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LARRY J & BONNIE P RUSSELL",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-25",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "RUSSELL",
        "authorized_official_first_name": "LARRY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "270-769-3717",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "R.PH."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "KY",
            "license": "P01397",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "KY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP #",
            "identifier": "1813131",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5401676100",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Medicine Shoppe",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• James E. Lane
• Warren Langford Sr., MABC, MAHSC, LCADC
• Lanham Counseling
• Krista D Lanham, APRN
• Kaitlynn Laning
• Laura L Larue, APRN
• Chanese Latimer
• Laura L Larue, Aprn-BC, PLLC
• Deborah Lawrence
• Jacquelyn Renee Lawrence, LPCC, NCC

• Community/Retail Pharmacy in Elizabethtown, KY
• Providers in Elizabethtown, 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.