MEDICARE: CENTRAL KENTUCKY APOTHECARY

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	333600000X	Pharmacy	P07288	KY
2	332B00000X	Durable Medical Equipment & Medical Supplies	P07288	KY
3	3336C0003X	Community/Retail Pharmacy

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	FLU0343	OTHER	KY	NGS-MEDICARE MASS IMMUNIZER

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
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	:	1497754923
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CENTRAL KENTUCKY APOTHECARY

Provider Business Mailing Address
First Line	:	100 E CUMBERLAND ST
Second Line	:
City	:	ALBANY
State	:	KY
Zip	:	42602-1206
Country	:	US
Telephone Number	:	606-387-6444
Fax Number	:	606-387-9224

Provider Business Practice Location Address
First Line	:	100 E CUMBERLAND ST
Second Line	:
City	:	ALBANY
State	:	KY
Zip	:	42602-1206
Country	:	US
Telephone Number	:	606-387-6444
Fax Number	:	606-387-9224

Authorized Official
Title or Position	:	PRESIDENT/CEO/OWNER
Name	:	ARICA V. COLLINS
Credential	:	PHARM D.
Telephone Number	:	606-387-6444

Provider Enumeration Date	:	07/18/2005
Last Update Date	:	12/14/2021

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Directions to “CENTRAL KENTUCKY APOTHECARY ” Practice Location

Language	Start Address	Practice Location

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