Organization
UNIVERSITY OF KENTUCKY
Active
Other names
UK Good Samaritan Retail Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
ELAINE DEBORD YOUNCE FHFMA (CHIEF OF PAYER ADMINISTRATION)
(859) 257-9521
Entity
Organization
Contact information
Practice address
310 SOUTH LIMESTONE ST, ROOM C-017, LEXINGTON, KY 40508-3008
(859) 218-4777
(859) 257-5590
Mailing address
310 SOUTH LIMESTONE ST, ROOM C-017, LEXINGTON, KY 40508-3008
(859) 218-4777
(859) 257-5590
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
P07636
KY
3336C0002X
Clinic Pharmacy
P07636
KY
3336C0003X
Community/Retail Pharmacy
P07636
KY
3336C0004X
Compounding Pharmacy
P07636
KY
3336M0002X
Mail Order Pharmacy
P07636
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
54008230
—
KY
Enumeration date
06/11/2014
Last updated
07/18/2022
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