=====================================================
General NPI Number Information
=====================================================
NPI Number | 1548963309
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | POOLE'S CLINICAL SOLUTIONS, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/22/2023
-----------------------------------------------------
Last Update Date | 05/07/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 102 W BROAD ST
-----------------------------------------------------
City | CENTRAL CITY
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 42330-1538
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 270-754-1545
-----------------------------------------------------
Fax | 270-754-9069
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 91
-----------------------------------------------------
City | LIVERMORE
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 42352-0091
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 270-486-1534
-----------------------------------------------------
Fax | 270-278-2369
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT/OWNER/PHARMACIST
-----------------------------------------------------
Name | MR. RON STEVEN POOLE
-----------------------------------------------------
Credential | R.PH.
-----------------------------------------------------
Telephone | 270-543-3886
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QH0100X
-----------------------------------------------------
Taxonomy Name | Health Service Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 261QP2300X
-----------------------------------------------------
Taxonomy Name | Primary Care Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------