Clay Medi Center Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

P07541 Issued in KY

Legal business name

CLAY MEDI CENTER PHARMACY LLC

Doing business as

Clay Medicenter Pharmacy

Practice address

509 Memorial Dr
Manchester, KY 40962-6195

Phone

(606) 598-7933

Fax

(606) 598-1887

NPI assigned

Dec 17, 2012

Last updated

Jun 20, 2013By 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

Robert Cruse

Title

Owner/Manager

Phone

(502) 432-3621

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• CLAY MEDICENTER PHARMACY Doing business as

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

{
    "created_epoch": "1355702400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1371686400000",
    "number": "1992041131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "509 MEMORIAL DR",
            "city": "MANCHESTER",
            "state": "KY",
            "postal_code": "409626195",
            "telephone_number": "606-598-7933",
            "fax_number": "606-598-1887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "509 MEMORIAL DR",
            "city": "MANCHESTER",
            "state": "KY",
            "postal_code": "409626195",
            "telephone_number": "606-598-7933",
            "fax_number": "606-598-1887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLAY MEDI CENTER PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-17",
        "last_updated": "2013-06-20",
        "status": "A",
        "authorized_official_last_name": "CRUSE",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "OWNER/MANAGER",
        "authorized_official_telephone_number": "502-432-3621"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "KY",
            "license": "P07541",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2139171",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CLAY MEDICENTER PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Leah Ann Collins

• Community/Retail Pharmacy in Manchester, KY
• Providers in Manchester, 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 Jun 20, 2013; 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.