Provider Demographics
NPI:1194830125
Name:SAVE-ON DRUGS OF CADIZ INC
Entity Type:Organization
Organization Name:SAVE-ON DRUGS OF CADIZ INC
Other - Org Name:SAVE-ON DRUGS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER,PIC,AO
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:CLEMENT
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:270-924-1191
Mailing Address - Street 1:PO BOX 390
Mailing Address - Street 2:
Mailing Address - City:CADIZ
Mailing Address - State:KY
Mailing Address - Zip Code:42211-0390
Mailing Address - Country:US
Mailing Address - Phone:270-522-3211
Mailing Address - Fax:270-522-5479
Practice Address - Street 1:266 MAIN ST
Practice Address - Street 2:
Practice Address - City:CADIZ
Practice Address - State:KY
Practice Address - Zip Code:42211-9155
Practice Address - Country:US
Practice Address - Phone:270-522-3211
Practice Address - Fax:270-522-5479
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-20
Last Update Date:2015-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 333600000X, 3336C0004X, 3336L0003X
KYP020183336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2028594OtherPK
KY54002977Medicaid
4949940001Medicare NSC