Healthcare Provider Details

I. General information

NPI: 1114563319
Provider Name (Legal Business Name): INSPIRE RX PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/22/2019
Last Update Date: 01/05/2021
Certification Date: 01/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

950 N MULBERRY ST STE 100A
ELIZABETHTOWN KY
42701-3629
US

IV. Provider business mailing address

950 N MULBERRY ST STE 100A
ELIZABETHTOWN KY
42701-3629
US

V. Phone/Fax

Practice location:
  • Phone: 270-769-0369
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: NATHANIEL ADAMS
Title or Position: PHARMACIST
Credential: PHARMD
Phone: 270-370-0005