Provider Demographics
NPI:1326489071
Name:UNIVERSITY OF KENTUCKY
Entity Type:Organization
Organization Name:UNIVERSITY OF KENTUCKY
Other - Org Name:UNIVERSITY HEALTH PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF OF PAYER ADMINISTRATION
Authorized Official - Prefix:
Authorized Official - First Name:ELAINE
Authorized Official - Middle Name:DEBORD
Authorized Official - Last Name:YOUNCE
Authorized Official - Suffix:
Authorized Official - Credentials:FHFMA
Authorized Official - Phone:859-257-9521
Mailing Address - Street 1:830 S LIMESTONE ST
Mailing Address - Street 2:ROOM 129
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40536-0001
Mailing Address - Country:US
Mailing Address - Phone:859-257-6451
Mailing Address - Fax:859-323-6898
Practice Address - Street 1:830 S LIMESTONE ST
Practice Address - Street 2:ROOM 129
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536-0001
Practice Address - Country:US
Practice Address - Phone:859-257-6451
Practice Address - Fax:859-323-6898
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-10
Last Update Date:2022-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYP07556333600000X, 3336C0002X, 3336C0003X, 3336C0004X, 3336M0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0002XSuppliersPharmacyClinic Pharmacy
No333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336M0002XSuppliersPharmacyMail Order Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY54008230Medicaid
KY54008230Medicaid