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MIDWAY PHARMACY OF CLARKSON INC NPI 1467439083


NPI Information

NPI: 1467439083
Provider Name: MIDWAY PHARMACY OF CLARKSON, INC

Doing Business As: MIDWAY PHARMACY

Classification: Pharmacy - 333600000X
Entity Type: Organization

CLIA Number: 18D2235170

Address:
408 EAST MAPLE STREET
CANEYVILLE, KY
ZIP 42721
Phone: (270) 879-6355
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MIDWAY PHARMACY OF CLARKSON, INC is a pharmacy in Caneyville, KY. The provider is a facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. MIDWAY PHARMACY OF CLARKSON, INC NPI is 1467439083. The provider is registered as an organization entity type.
The provider Is Doing Business As Midway Pharmacy.

The provider's business location address is:

408 EAST MAPLE STREET
CANEYVILLE, KY
ZIP 42721
Phone: (270) 879-6355
Fax: (270) 879-6143

The provider's authorized official is Trevor Ray .
The authorized official title is R.ph./secretary and has the following contact phone number (270) 879-6355.

The CLIA number assigned to this NPI record is 18D2235170 - pharmacy with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/23/2005 and was last updated on 3/7/2023.


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 SuppliesPO6776KENTUCKYNo
2333600000XPharmacyPO6776KENTUCKYYes

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
17100165550MEDICAIDKENTUCKY
21827558OTHERKENTUCKYNCPDP ID NUMBER

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.