Cloverdale Drugs, Inc

Primary specialty

PharmacyTaxonomy code 333600000X

Legal business name

CLOVERDALE DRUGS, INC

Doing business as

Cloverdale Drugs

Practice address

900 N Main St
Cloverdale, IN 46120-8506

Phone

(765) 795-4100

Fax

(765) 795-5310

NPI assigned

Sep 8, 2006

Last updated

Mar 24, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kennedy RyanNPI 1609491554

Title

Owner

Phone

(765) 795-4100

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Cloverdale Drugs Doing business as

Medicare fee-for-service enrollment

Enrolled in IN2 enrollments

Enrollment records 2

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

CLIA laboratory certificates

Medicare medical equipment & supply locations

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kennedy Ryan

  • Pharmacist
  • Cloverdale, IN
  • NPI 1609491554
  NPD Authorized official
• Benjamin J Laney, PHARMD

  • Pharmacist
  • Cloverdale, IN
  • NPI 1548447071
  NPD (past)
• Jack Newson, RPH

  • Pharmacist
  • Cloverdale, IN
  • NPI 1356408181
  NPD (past)
• Cassie Anne Perras, PHARMD

  • Pharmacist
  • Cloverdale, IN
  • NPI 1487161154
  NPD (past)
• Whitney Anne Smith

  • Pharmacist
  • Cloverdale, IN
  • NPI 1982115473
  NPD (past)

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

{
    "created_epoch": "1157673600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648080000000",
    "number": "1780788927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 357",
            "city": "CLOVERDALE",
            "state": "IN",
            "postal_code": "461200357",
            "telephone_number": "765-795-4100",
            "fax_number": "765-795-5310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 N MAIN ST",
            "city": "CLOVERDALE",
            "state": "IN",
            "postal_code": "461208506",
            "telephone_number": "765-795-4100",
            "fax_number": "765-795-5310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLOVERDALE DRUGS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-08",
        "last_updated": "2022-03-24",
        "certification_date": "2022-03-24",
        "status": "A",
        "authorized_official_last_name": "RYAN",
        "authorized_official_first_name": "KENNEDY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "765-795-4100"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NABP",
            "identifier": "1509934",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100300610",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cloverdale Drugs",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Cloverdale Drugs",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Scott Alan Armitage, DDS
• Eleanor Bings
• Cloverdale Community School Corporation
• Cloverdale Community Schools
• Daviess County Hospital (Aperion Care Summerfield)
• Valerie Fralic, NP
• Riley Goetz
• Lisa Ann Hettich, PHARMD, CGP
• Jasmine Marie Johnson, PA-C

• Pharmacy in Cloverdale, IN
• Providers in Cloverdale, IN by specialty
• Pharmacy in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2022; 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.