Eastside Pharmacy of Cynthiana, Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

P00966 Issued in KY

Legal business name

EASTSIDE PHARMACY OF CYNTHIANA, INC

Practice address

430 E Pleasant St Ste 2
Cynthiana, KY 41031-1614

Phone

(859) 234-6800

NPI assigned

Nov 11, 2006

Last updated

Aug 22, 2020By 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

Nancy Judy Walker, RPHNPI 1669094876

Title

Pharmacist-in-Charge

Phone

(859) 234-6800

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

Locations

Practitioners 3

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.

• Nancy Judy Walker, RPH

  • Pharmacist
  • Cynthiana, KY
  • NPI 1669094876
  NPD Authorized official
• Kelli Abadi

  • Pharmacist
  • Cynthiana, KY
  • NPI 1285242057
  NPD (past)
• Daniel Brent Adams, PHARM.D.

  • Pharmacist
  • Cynthiana, KY
  • NPI 1124289590
  NPD (past)

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

{
    "created_epoch": "1163203200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1942371042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 E PLEASANT ST STE 2",
            "city": "CYNTHIANA",
            "state": "KY",
            "postal_code": "410311614",
            "telephone_number": "859-234-6800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 E PLEASANT ST STE 2",
            "city": "CYNTHIANA",
            "state": "KY",
            "postal_code": "410311614",
            "telephone_number": "859-234-6800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTSIDE PHARMACY OF CYNTHIANA, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-11",
        "last_updated": "2020-08-22",
        "certification_date": "2020-05-11",
        "status": "A",
        "authorized_official_last_name": "WALKER",
        "authorized_official_first_name": "NANCY",
        "authorized_official_middle_name": "JUDY",
        "authorized_official_title_or_position": "PHARMACIST-IN-CHARGE",
        "authorized_official_telephone_number": "859-234-6800",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "KY",
            "license": "P00966",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "54013339",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "1809106",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Douglas Crutcher, PSC
• Dr Brett a Hines PSC (Cynthiana Vision Center)
• Peggy Lynn Dunn
• Durable Medical Supply Home Health Inc. (Cynthiana Durable Medical Supply)
• Dwight E Lewis, MD, PSC
• Edgemont Healthcare, Inc.
• Edgemont Manor
• Family Care Associates, PSC
• William Ballard Faulkner III, DMD
• FDC Cynthiana LLC (Friendly Dental Co)

• Community/Retail Pharmacy in Cynthiana, KY
• Providers in Cynthiana, 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 Aug 22, 2020; 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.