=====================================================
General NPI Number Information
=====================================================
NPI Number | 1285973313
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ROBERTS' PHARMACY LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/09/2013
-----------------------------------------------------
Last Update Date | 10/31/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 150 WESTVIEW SHOPPING CTR
-----------------------------------------------------
City | ALBANY
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 42602-1600
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 606-557-1213
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 809
-----------------------------------------------------
City | ALBANY
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 42602-0809
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 606-557-1213
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PIC
-----------------------------------------------------
Name | DR. LAURA ANN ROBERTS
-----------------------------------------------------
Credential | PHARMACIST
-----------------------------------------------------
Telephone | 606-557-1213
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332B00000X
-----------------------------------------------------
Taxonomy Name | Durable Medical Equipment & Medical Supplies
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 3336C0003X
-----------------------------------------------------
Taxonomy Name | Community/Retail Pharmacy
-----------------------------------------------------
License Number | P07538
-----------------------------------------------------
License Number State | KY
-----------------------------------------------------