=====================================================
General NPI Number Information
=====================================================
NPI Number | 1518362581
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CASEY COUNTY HOSPITAL DISTRICT
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/03/2014
-----------------------------------------------------
Last Update Date | 06/27/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 187 WOLFORD AVE STE A
-----------------------------------------------------
City | LIBERTY
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 42539-3278
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 606-787-0119
-----------------------------------------------------
Fax | 606-787-5033
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 187 WOLFORD AVE STE A
-----------------------------------------------------
City | LIBERTY
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 42539-3278
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 606-787-0119
-----------------------------------------------------
Fax | 606-787-5033
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | RETAIL PHARMACY DIRECTOR
-----------------------------------------------------
Name | JOHN WILCHER
-----------------------------------------------------
Credential | PHARMD
-----------------------------------------------------
Telephone | 270-403-2466
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 333600000X
-----------------------------------------------------
Taxonomy Name | Pharmacy
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 3336C0003X
-----------------------------------------------------
Taxonomy Name | Community/Retail Pharmacy
-----------------------------------------------------
License Number | P07658
-----------------------------------------------------
License Number State | KY
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 3336C0003X
-----------------------------------------------------
Taxonomy Name | Community/Retail Pharmacy
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------