NPIMap

Organization Active NPI

Mikels Drive in Pharmacy

  • Durable Medical Equipment & Medical Supplies
  • Middlesboro, KY
National Provider Identifier
1972787885
Registry record updated Jun 11, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
PO1111 Issued in KY
Legal business name
MIKELS DRIVE IN PHARMACY
Practice address
1928 Cumberland Ave
Middlesboro, KY 40965-1231
Phone
(606) 248-1052
Fax
(606) 248-6598
NPI assigned
Dec 27, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2009

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

Authorized official

Name
Mr. Mikel Byrne, PHARMACIST
Title
President
Phone
(606) 248-1052

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X PO1111 KY Primary

Addresses

Primary practice location

1928 Cumberland Ave
Middlesboro, KY 40965-1231

Mailing address

1928 Cumberland Ave
Middlesboro, KY 40965-1231
Phone (606) 248-1052

Other identifiers 1

IdentifierTypeStateIssuer
90180076MedicaidKY

National Provider Directory

National Provider Directory
Tax ID family
Mikels Drive in Pharmacy3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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": "1198713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1244678400000",
    "number": "1972787885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1928 CUMBERLAND AVE",
            "city": "MIDDLESBORO",
            "state": "KY",
            "postal_code": "409651231",
            "telephone_number": "606-248-1052",
            "fax_number": "606-248-6598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1928 CUMBERLAND AVE",
            "city": "MIDDLESBORO",
            "state": "KY",
            "postal_code": "409651231",
            "telephone_number": "606-248-1052",
            "fax_number": "606-248-6598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIKELS DRIVE IN PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-27",
        "last_updated": "2009-06-11",
        "status": "A",
        "authorized_official_last_name": "BYRNE",
        "authorized_official_first_name": "MIKEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "606-248-1052",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PHARMACIST"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "KY",
            "license": "PO1111",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "90180076",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Middlesboro, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2009; 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.