Blacklog Apothecary Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

BLACKLOG APOTHECARY INC

Doing business as

Medicine Shoppe

Practice address

62 Kirk PLZ
Inez, KY 41224-6501

Phone

(606) 298-7774

Fax

(606) 298-4975

NPI assigned

Jan 30, 2007

Last updated

Mar 7, 2023By 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

Randall Berry Chaffin, RPH

Title

Owner Pharmacist

Phone

(606) 298-7774

Specialties & licenses 4

Addresses

Other names 1

• MEDICINE SHOPPE Doing business as

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

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

Medicare medical equipment & supply locations

Locations

Practitioners 1

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.

• Donald L Chaffin Jr., M.D.

  • Family Medicine Physician
  • Inez, KY
  • NPI 1902849912
  NPD (past)

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1831235480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "62 KIRK PLZ",
            "city": "INEZ",
            "state": "KY",
            "postal_code": "412246501",
            "telephone_number": "606-298-7774",
            "fax_number": "606-298-4975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "62 KIRK PLZ",
            "city": "INEZ",
            "state": "KY",
            "postal_code": "412246501",
            "telephone_number": "606-298-7774",
            "fax_number": "606-298-4975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLACKLOG APOTHECARY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-30",
        "last_updated": "2023-03-07",
        "certification_date": "2020-10-30",
        "status": "A",
        "authorized_official_last_name": "CHAFFIN",
        "authorized_official_first_name": "RANDALL",
        "authorized_official_middle_name": "BERRY",
        "authorized_official_title_or_position": "OWNER PHARMACIST",
        "authorized_official_telephone_number": "606-298-7774",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "KY",
            "license": "P01894",
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "KY",
            "license": "P01894",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "KY",
            "license": "P01894",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MEDICINE SHOPPE",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MEDICINE SHOPPE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Big Sandy Health Care Inc (Martin County Pharmacy)
• Big Sandy Health Care, Inc (Eden Elementary School Clinic)
• Big Sandy Health Care, Inc (Martin County Community Health Center)
• Big Sandy Health Care, Inc (Inez Elementary School Clinic)
• Big Sandy Health Care, Inc (Martin County High School Clinic)
• Ashley Blair
• Bombshell Aesthetics & Weight Loss Clinic PLLC
• Donald L Chaffin Jr., M.D.
• Community Alternatives Kentucky
• Consolidated Health Systems (Martin County Community Care Clinic)

• Community/Retail Pharmacy in Inez, KY
• Providers in Inez, 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 Mar 7, 2023; 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.