Laker Drug Inc.

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

P06839 Issued in KY

Legal business name

LAKER DRUG INC.

Doing business as

laker drug

Practice address

92 Joe T Petty Dr
Russell Springs, KY 42642-8543

Phone

(270) 866-7787

NPI assigned

Aug 13, 2006

Organization subpart

No

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

Authorized official

Name

Timothy D Carnes

Title

President

Phone

(270) 343-2336

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• laker drug Doing business as

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

{
    "created_epoch": "1155427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205712000000",
    "number": "1992718084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "92 JOE T PETTY DR",
            "city": "RUSSELL SPRINGS",
            "state": "KY",
            "postal_code": "426428543",
            "telephone_number": "270-866-7787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "92 JOE T PETTY DR",
            "city": "RUSSELL SPRINGS",
            "state": "KY",
            "postal_code": "426428543",
            "telephone_number": "270-866-7787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKER DRUG INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-13",
        "last_updated": "2008-03-17",
        "status": "A",
        "authorized_official_last_name": "CARNES",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "270-343-2336"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "KY",
            "license": "P06839",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "KY",
            "license": "P06839",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "54004593",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "90009507",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "laker drug",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Barry Lawson, RPH
• Terri Susanne Lee, OD

• Community/Retail Pharmacy in Russell Springs, KY
• Providers in Russell Springs, 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 Mar 17, 2008; 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.