NPIMap

Organization Active NPI

Burgess Drug Store Inc.

  • Pharmacy
  • Monticello, KY
National Provider Identifier
1942847686
Registry record updated Dec 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
Legal business name
BURGESS DRUG STORE INC.
Practice address
1 S. Creek Dr.
Ste. #122
Monticello, KY 42633
Phone
(606) 376-5043
Fax
(606) 376-5466
NPI assigned
Dec 2, 2019
Last updated
Dec 2, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2019

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

Authorized official

Name
Dr. Jaime P. Ball, PHARMD
Title
Dr./Owner
Phone
(606) 310-3910

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X NU Primary
Community/Retail Pharmacy 3336C0003X NU

Addresses

Primary practice location

1 S. Creek Dr.
Ste. #122
Monticello, KY 42633

Mailing address

PO Box 279
Whitley City, KY 42653
Phone (606) 376-5043

National Provider Directory

National Provider Directory
Tax ID family
Burgess Drug Store Inc 34 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

NPI Registry JSON

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

{
    "created_epoch": "1575244800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1575244800000",
    "number": "1942847686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 279",
            "city": "WHITLEY CITY",
            "state": "KY",
            "postal_code": "42653",
            "telephone_number": "606-376-5043",
            "fax_number": "606-376-5466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 S. CREEK DR.",
            "address_2": "STE. #122",
            "city": "MONTICELLO",
            "state": "KY",
            "postal_code": "42633",
            "telephone_number": "606-376-5043",
            "fax_number": "606-376-5466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BURGESS DRUG STORE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-02",
        "last_updated": "2019-12-02",
        "status": "A",
        "authorized_official_last_name": "BALL",
        "authorized_official_first_name": "JAIME",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "DR./OWNER",
        "authorized_official_telephone_number": "606-310-3910",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monticello, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.