Provider Demographics
NPI:1073731717
Name:MED CARE PHARMACY - FLORENCE DME
Entity Type:Organization
Organization Name:MED CARE PHARMACY - FLORENCE DME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST-OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOE
Authorized Official - Middle Name:
Authorized Official - Last Name:MASHNI
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:859-689-7130
Mailing Address - Street 1:350 ARISTOCRAT DR STE B
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:KY
Mailing Address - Zip Code:41042-3280
Mailing Address - Country:US
Mailing Address - Phone:859-689-7130
Mailing Address - Fax:869-689-6219
Practice Address - Street 1:350 ARISTOCRAT DR STE B
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:KY
Practice Address - Zip Code:41042-3280
Practice Address - Country:US
Practice Address - Phone:859-689-7130
Practice Address - Fax:869-689-6219
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY9006073332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY90006073Medicaid