# WESTERN STATE HOSPITAL PHARMACY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043497480
- **Authorized official:** MR. ROGER WESTFALL (DIRECTOR OF ADMINISTRATIVE SERVICES)
- **Authorized official phone:** (270) 889-6025

## Contact information

- **Practice address:** 2400 RUSSELLVILLE RD, HOPKINSVILLE, KY 42240-8095
- **Practice address phone:** (270) 889-6025
- **Practice address fax:** (270) 889-5062
- **Mailing address:** 2400 RUSSELLVILLE RD, HOPKINSVILLE, KY 42240-8095
- **Mailing address phone:** (270) 889-6025
- **Mailing address fax:** (270) 889-5062

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336I0012X | Institutional Pharmacy | P05010 | KY | Yes |
| 3336I0012X | Institutional Pharmacy | P06561 | KY | — |

## Other

- **Enumeration date:** 01/29/2008
- **Last updated:** 01/29/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 5402559800 | — | KY |