MEDICARE: S & K APOTHECARY INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies
2	333600000X	Pharmacy
3	3336C0003X	Community/Retail Pharmacy	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	2095061	OTHER	PK
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1235159070
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	S & K APOTHECARY INC.

Provider Business Mailing Address
First Line	:	226 MAIN STREET
Second Line	:
City	:	BAXTER
State	:	TN
Zip	:	38544
Country	:	US
Telephone Number	:	931-858-3714
Fax Number	:	931-858-2491

Provider Business Practice Location Address
First Line	:	226 MAIN STREET
Second Line	:
City	:	BAXTER
State	:	TN
Zip	:	38544
Country	:	US
Telephone Number	:	931-858-3714
Fax Number	:	931-858-2491

Authorized Official
Title or Position	:	PRESIDENT
Name	:	SAMANTHA HENSLEY
Credential	:
Telephone Number	:	931-858-3714

Provider Enumeration Date	:	07/21/2006
Last Update Date	:	02/27/2023

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Directions to “S & K APOTHECARY INC. ” Practice Location

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