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Bardwell Pharmacy LLC

Organization Active NPI Long Term Care Pharmacy · Bardwell, KY

NPI 1750879524 · NPPES record last updated Nov 18, 2020

Key facts

NPI
1750879524
Entity type
Organization (NPI type 2)
Primary specialty
Long Term Care Pharmacy 3336L0003X
License
P07718 (KY)
Legal business name
BARDWELL PHARMACY LLC
Practice address
178 US Hwy 51N
Bardwell, KY 42023
Phone
(270) 628-5445
Fax
(618) 628-3179
NPI assigned
Apr 27, 2018
Organization subpart
Yes
Parent organization (as reported)
BARDWELL PHARMACY LLC

Authorized official

Name
Chris Augustus
Title
Owner
Phone
(270) 628-5445

Corporate family (same tax ID) 1

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
Bardwell Pharmacy LLC (2 organizations share this tax ID)
Part of
Bardwell Pharmacy LLC

Locations

178 US Highway 51 N
Bardwell, KY 42023
Phone (270) 628-5445

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Long Term Care Pharmacy 3336L0003X P07718 KY Yes

Addresses

Primary practice location

178 US Hwy 51N
Bardwell, KY 42023

Mailing address

178 US Hwy 51N
Bardwell, KY 42023
Phone (270) 628-5445

Other identifiers

IdentifierTypeStateIssuer
2177467OtherPK
54020524MedicaidKY

Other names

  • Bardwell Pharmacy LTC Doing business as

Other providers in Bardwell, KY

All providers in Bardwell, KY · Long Term Care Pharmacy in Kentucky

Sources for this page

Verify at the official NPI Registry.