Provider Demographics
NPI:1386646974
Name:INSTITUTIONAL PHARMACY INC
Entity Type:Organization
Organization Name:INSTITUTIONAL PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:FORCHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:606-528-9600
Mailing Address - Street 1:PO BOX 1450
Mailing Address - Street 2:
Mailing Address - City:CORBIN
Mailing Address - State:KY
Mailing Address - Zip Code:40702-1450
Mailing Address - Country:US
Mailing Address - Phone:606-528-9600
Mailing Address - Fax:606-528-3873
Practice Address - Street 1:108 E 6TH ST
Practice Address - Street 2:
Practice Address - City:CORBIN
Practice Address - State:KY
Practice Address - Zip Code:40701-1422
Practice Address - Country:US
Practice Address - Phone:606-528-9600
Practice Address - Fax:606-528-3853
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-12
Last Update Date:2014-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYP06791332BP3500X, 333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY001639570OtherBCBS HIGHMARK
KY90008483Medicaid
KY000000334951OtherANTHEM BCBS KY
KY0007732614OtherAETNA
KY=========OtherTAX IDENTIFICATION
KY001639570OtherBCBS HIGHMARK