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MIDWAY PHARMACY OF CLARKSON INC NPI 1750895090


NPI Information

NPI: 1750895090
Provider Name: MIDWAY PHARMACY OF CLARKSON INC

: MIDWAY PHARMACY

Classification: Pharmacy - 3336C0003X
Entity Type: Organization

Specialization: Community/Retail Pharmacy

CLIA Number: 18D2235154

Address:
1640 2ND ST
HENDERSON, KY
ZIP 42420
Phone: (270) 212-1001
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MIDWAY PHARMACY OF CLARKSON INC is a community/retail pharmacy pharmacy in Henderson, KY. The provider is a pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. MIDWAY PHARMACY OF CLARKSON INC NPI is 1750895090. The provider is registered as an organization entity type.
The provider Midway Pharmacy.

The provider's business location address is:

1640 2ND ST
HENDERSON, KY
ZIP 42420-364
Phone: (270) 212-1001
Fax: (855) 782-5261

The provider's authorized official is Trevor Ray .
The authorized official title is Secretary/owner and has the following contact phone number (270) 212-1001.

The CLIA number assigned to this NPI record is 18D2235154 - pharmacy with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/22/2017 and was last updated on 4/19/2018.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1332B00000XDurable Medical Equipment & Medical SuppliesNo
2333600000XPharmacyNo
33336C0003XPharmacyCommunity/Retail PharmacyP07865KENTUCKYYes
43336C0004XPharmacyCompounding PharmacyNo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
12174033OTHERPK
27100504950MEDICAIDKENTUCKY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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