Lake Cumberland Pharmacy LLC
Lake Cumberland Pharmacy LLC is a Parenteral & Enteral Nutrition Supplies (DME) in Russell Springs, Kentucky. Licensed in Kentucky. Registered with an NPI since 2011.
- Licensed in
- KY
- In the registry since
- 2011
- Specialties on file
- 3
What do these letters mean?
- LLC — Limited liability company
- A form of business registration, not a clinical qualification.
Practice location Address checks out
124 Dowell RdRussell Springs, KY 42642-4278
Phone: (270) 866-2686
Fax: (270) 866-6566
Show map & directions
Directions in Google Maps · Apple Maps · OpenStreetMap
Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Community/Retail Pharmacy (primary) | Taxonomy 3336C0003X · Licence P07440 (KY) |
|---|---|
| Parenteral & Enteral Nutrition Supplies (DME) | Taxonomy 332BP3500X |
| Pharmacy | Taxonomy 333600000X |
Record details
| NPI number | 1912201906 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Jonathan Grider — Managing Member · (270) 858-6400 |
| Other names | Lake Cumberland Pharmacy #2; Lake Cumberland Pharmacy #2 |
| NPI enumerated | January 5, 2011 |
| Last updated in NPPES | October 7, 2022 |
| Certification date | October 7, 2022 |
| Mailing address | Po Box 72, Russell Springs, KY 42642-0072 |
Other providers in Russell Springs
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Lake Cumberland Pharmacy LLC
2431C Lakeway Dr, Russell Springs, KY 42642-4510 · (270) 858-6400