Provider Demographics
NPI:1073526158
Name:SCIENCE HILL DRUG, LLC
Entity Type:Organization
Organization Name:SCIENCE HILL DRUG, LLC
Other - Org Name:LONDON VALU RITE PHARMACY, INC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:CARNES
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:270-566-1074
Mailing Address - Street 1:5775 N HIGHWAY 27
Mailing Address - Street 2:
Mailing Address - City:SCIENCE HILL
Mailing Address - State:KY
Mailing Address - Zip Code:42553-9140
Mailing Address - Country:US
Mailing Address - Phone:606-423-9959
Mailing Address - Fax:
Practice Address - Street 1:5775 N HIGHWAY 27
Practice Address - Street 2:
Practice Address - City:SCIENCE HILL
Practice Address - State:KY
Practice Address - Zip Code:42553-9140
Practice Address - Country:US
Practice Address - Phone:606-423-9959
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-13
Last Update Date:2020-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYP06496332B00000X, 3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY54035126Medicaid
KY90009408Medicaid
KY0842600002Medicare NSC