Seth Larence Thacker, RPH

Individual provider Active NPI Pharmacist · Flatwoods, KY

NPI 1962098038 · NPPES record last updated Dec 14, 2020

Key facts

NPI
1962098038
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist 183500000X
License
020602 (KY)
Practice address
2409 Argillite Rd
Flatwoods, KY 41139-1955
Phone
(606) 833-8027
Fax
(606) 833-2567
NPI assigned
Dec 14, 2020
Sex
Male
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
020602KYMDPharmacist
03439500OHMDPharmacist
RO0010918WVMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Kentucky CVS Pharmacy., L.L.C. Past
since Dec 16, 2020
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 03439500 OH
Pharmacist 183500000X RO0010918 WV
Pharmacist 183500000X 020602 KY Yes

Addresses

Primary practice location

2409 Argillite Rd
Flatwoods, KY 41139-1955

Mailing address

419 11TH Ave
Huntington, WV 25701-3118
Phone (304) 544-8425

Electronic endpoints

TypeEndpointUseAffiliation
Direct Messaging Address rx02380@cvshealth.com

Other providers in Flatwoods, KY

All providers in Flatwoods, KY · Pharmacist in Kentucky

Sources for this page

Verify at the official NPI Registry.