Provider Demographics
NPI:1376655225
Name:MCMEANS PHARMACY INC
Entity Type:Organization
Organization Name:MCMEANS PHARMACY INC
Other - Org Name:MCMEANS PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:MCMEANS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:606-325-8400
Mailing Address - Street 1:PO BOX 869
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:KY
Mailing Address - Zip Code:41105-0869
Mailing Address - Country:US
Mailing Address - Phone:604-325-8400
Mailing Address - Fax:606-324-3112
Practice Address - Street 1:2920 CARTER AVE
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:KY
Practice Address - Zip Code:41101-1943
Practice Address - Country:US
Practice Address - Phone:606-325-8400
Practice Address - Fax:606-324-3112
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2013-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
KYP020403336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2030705OtherPK
KY54022272Medicaid
2030705OtherPK