Provider Demographics
NPI:1073865408
Name:BISHOP PHARMACY INC
Entity Type:Organization
Organization Name:BISHOP PHARMACY INC
Other - Org Name:RICKETTS PHARMACY, INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:RICKETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:606-515-6134
Mailing Address - Street 1:PO BOX 598
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:KY
Mailing Address - Zip Code:40769-0598
Mailing Address - Country:US
Mailing Address - Phone:606-515-6134
Mailing Address - Fax:606-515-6093
Practice Address - Street 1:486 N HIGHWAY 25 W
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:KY
Practice Address - Zip Code:40769-1560
Practice Address - Country:US
Practice Address - Phone:606-515-6134
Practice Address - Fax:606-515-6093
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-09
Last Update Date:2017-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY171230332B00000X
333600000X
KYP075253336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100243070Medicaid
2137222OtherPK
KY7100243070Medicaid