Organization
PAT'S PHARMACY, INC.
Active
Organization
PAT'S PHARMACY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOSEPH KELLY JOHNSON (PRESIDENT)
(270) 692-4950
Entity
Organization
Contact information
Practice address
498 W. MAIN ST., LEBANON, KY 40033-1362
(270) 692-4950
(270) 692-2320
Mailing address
498 W. MAIN ST., LEBANON, KY 40033-1362
(270) 692-4950
(270) 692-2320
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
007247
KY
332B00000X
Durable Medical Equipment & Medical Supplies
90006735
KY
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
45542818
KY
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
54019211
KY
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000070377
ANTHEM BCBS
KY
01
—
45542818
MEDICAID; EPSDT PROVIDER NO.
KY
05
—
54019211
—
KY
05
—
90006735
—
KY
Enumeration date
10/02/2006
Last updated
08/16/2022
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up