Organization Active NPI

Yates Pharmacy LLC

  • Community/Retail Pharmacy
  • Russellville, KY
National Provider Identifier
1740615491
Registry record updated Nov 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
P07597 Issued in KY
Legal business name
YATES PHARMACY LLC
Doing business as
Yates Pharmacy LLC
Practice address
432 Hopkinsville Rd
Russellville, KY 42276-1284
Phone
(270) 726-8451
Fax
(270) 726-8696
NPI assigned
Sep 12, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2016

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

Authorized official

Name
Scott Yates, PHARMDNPI 1356851232
Title
President/Owner
Phone
(270) 726-8451

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X P07597 KY Primary

Addresses

Primary practice location

432 Hopkinsville Rd
Russellville, KY 42276-1284

Mailing address

432 Hopkinsville Rd
Russellville, KY 42276-1284
Phone (270) 726-8451

Other identifiers 2

IdentifierTypeStateIssuer
7100262540MedicaidKY
2142884OtherPK

Other names 1

  • Yates Pharmacy LLC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20140522001792 KY DME Supplier - Pharmacy 0941423784 Practice locations: Russellville, KY
O20140623002581 KY Part B Supplier - Mass Immunization (Roster Biller Only) 0941423784 Practice locations: Russellville, KY

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
18D2209008Yates Pharmacy432 Hopkinsville Rd, Russellville, KY 42276Certificate of waiverJan 10, 2027

National Provider Directory

National Provider Directory

Locations

432 Hopkinsville Rd
Russellville, KY 42276
Phone (270) 726-8451

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1378944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1479254400000",
    "number": "1740615491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "432 HOPKINSVILLE RD",
            "city": "RUSSELLVILLE",
            "state": "KY",
            "postal_code": "422761284",
            "telephone_number": "270-726-8451",
            "fax_number": "270-726-8696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "432 HOPKINSVILLE RD",
            "city": "RUSSELLVILLE",
            "state": "KY",
            "postal_code": "422761284",
            "telephone_number": "270-726-8451",
            "fax_number": "270-726-8696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YATES PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-12",
        "last_updated": "2016-11-16",
        "status": "A",
        "authorized_official_last_name": "YATES",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "270-726-8451",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "KY",
            "license": "P07597",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100262540",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2142884",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Yates Pharmacy LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Russellville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.