Organization Active NPI

Grant Pharmacist Group Inc

  • Community/Retail Pharmacy
  • Dry Ridge, KY
National Provider Identifier
1790899771
Registry record updated Jan 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
P07272 Issued in KY
Legal business name
GRANT PHARMACIST GROUP INC
Practice address
40 Broadway St
Dry Ridge, KY 41035-9762
Phone
(859) 823-0200
Fax
(859) 823-4500
NPI assigned
Aug 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2015

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

Authorized official

Name
Heather Fronk, PHRMD
Title
Partner
Phone
(606) 845-3421

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Community/Retail Pharmacy 3336C0003X P07272 KY Primary
Compounding Pharmacy 3336C0004X
Managed Care Organization Pharmacy 3336M0003X
Specialty Pharmacy 3336S0011X

Addresses

Primary practice location

40 Broadway St
Dry Ridge, KY 41035-9762

Mailing address

40 Broadway St
Dry Ridge, KY 41035-9762
Phone (859) 823-0200

Other identifiers 2

IdentifierTypeStateIssuer
2034093OtherPK
7100055140MedicaidKY

Other names 1

  • TOTAL CARE PHARMACY Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111027000250 KY Part B Supplier - Mass Immunization (Roster Biller Only) 0547460057 1 other NPI on this enrollment
Practice locations: Crittenden, KY

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

40 Broadway St
Dry Ridge, KY 41035
Phone (859) 823-0200

NPI Registry JSON

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421366400000",
    "number": "1790899771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 BROADWAY ST",
            "city": "DRY RIDGE",
            "state": "KY",
            "postal_code": "410359762",
            "telephone_number": "859-823-0200",
            "fax_number": "859-823-4500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 BROADWAY ST",
            "city": "DRY RIDGE",
            "state": "KY",
            "postal_code": "410359762",
            "telephone_number": "859-823-0200",
            "fax_number": "859-823-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRANT PHARMACIST GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-18",
        "last_updated": "2015-01-16",
        "status": "A",
        "authorized_official_last_name": "FRONK",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "606-845-3421",
        "authorized_official_credential": "PHRMD"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "KY",
            "license": "P07272",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336M0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Managed Care Organization Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2034093",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100055140",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TOTAL CARE PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dry Ridge, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.