Healthcare Provider Details

I. General information

NPI: 1114539822
Provider Name (Legal Business Name): B&B PHARMACY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2020
Last Update Date: 06/07/2022
Certification Date: 05/31/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

126 SHADOWMEADE LANE UNIT 2
MOUNT WASHINGTON KY
40047
US

IV. Provider business mailing address

126 SHADOWMEADE LANE UNIT 2
MOUNT WASHINGTON KY
40047
US

V. Phone/Fax

Practice location:
  • Phone: 502-538-5000
  • Fax: 502-538-0330
Mailing address:
  • Phone: 502-538-5000
  • Fax: 502-538-0330

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: ELLEN KRAJEWSKI BARGER
Title or Position: PIC
Credential: PHARMD
Phone: 502-543-8200