State Pharm Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

P07455 Issued in KY

Legal business name

STATE PHARM INC

Doing business as

State Pharm

Practice address

825 S 6TH St
Louisville, KY 40203-2123

Phone

(502) 583-5636

Fax

(502) 562-1235

NPI assigned

Feb 19, 2010

Organization subpart

No

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

Authorized official

Name

Kim Gorski

Title

Owner

Phone

(502) 583-5636

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• State Pharm Doing business as

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

{
    "created_epoch": "1266537600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433894400000",
    "number": "1720300684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 S 6TH ST",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402032123",
            "telephone_number": "502-583-5636",
            "fax_number": "502-562-1235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 S 6TH ST",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402032123",
            "telephone_number": "502-583-5636",
            "fax_number": "502-562-1235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE PHARM INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-19",
        "last_updated": "2015-06-10",
        "status": "A",
        "authorized_official_last_name": "GORSKI",
        "authorized_official_first_name": "KIM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "502-583-5636"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "KY",
            "license": "P07455",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2125320",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "State Pharm",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Louisville, KY
• Providers in Louisville, 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 Jun 10, 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.