Provider Demographics
NPI:1093891665
Name:BARR-THORN ENTERPRISES, INC.
Entity Type:Organization
Organization Name:BARR-THORN ENTERPRISES, INC.
Other - Org Name:NOVA PHARMACY DIABETES CARE & EDUCATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PIC/VP
Authorized Official - Prefix:
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:C
Authorized Official - Last Name:THORNBURY
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:606-432-6959
Mailing Address - Street 1:PO BOX 2048
Mailing Address - Street 2:
Mailing Address - City:GRUNDY
Mailing Address - State:VA
Mailing Address - Zip Code:24614-2048
Mailing Address - Country:US
Mailing Address - Phone:276-935-4777
Mailing Address - Fax:276-935-2269
Practice Address - Street 1:1330 S MAYO TRL STE 102
Practice Address - Street 2:
Practice Address - City:PIKEVILLE
Practice Address - State:KY
Practice Address - Zip Code:41501-2321
Practice Address - Country:US
Practice Address - Phone:606-432-2274
Practice Address - Fax:606-433-9816
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-27
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA9101535332B00000X
KY90003021332B00000X
1145660002332B00000X
KYP06583333600000X
VA02140000551333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000239278OtherBLUE CROSS/BLUE SHIELD
842863OtherASSOC. OF DIABETES CARE & EDUCATION SERVICES (ADCES)
VA9101535Medicaid
KYP06583OtherSTATE LIC
KY90003021Medicaid
149093800OtherDEPT OF LABOR
1826544OtherNCPDP
KY54001151Medicaid
VA08500509Medicaid
BN6860476OtherFEDERAL DEA