Provider Demographics
NPI:1306198601
Name:ASCLEPION INC.
Entity Type:Organization
Organization Name:ASCLEPION INC.
Other - Org Name:SACRAMENTO PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/PIC
Authorized Official - Prefix:DR
Authorized Official - First Name:JON
Authorized Official - Middle Name:GREGG
Authorized Official - Last Name:HENRY
Authorized Official - Suffix:
Authorized Official - Credentials:RPH, PHARMD
Authorized Official - Phone:270-977-7846
Mailing Address - Street 1:411 COLLEGE ST
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42345-1713
Mailing Address - Country:US
Mailing Address - Phone:270-977-7846
Mailing Address - Fax:
Practice Address - Street 1:750 MAIN ST
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:KY
Practice Address - Zip Code:42372-9405
Practice Address - Country:US
Practice Address - Phone:270-736-2999
Practice Address - Fax:270-736-2299
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-10
Last Update Date:2013-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYP075223336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy