Provider Demographics
NPI:1417377151
Name:NORTON PHARMACIES, PLLC
Entity Type:Organization
Organization Name:NORTON PHARMACIES, PLLC
Other - Org Name:NORTON HEALTHCARE PHARMACY-BROWNSBORO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP MANAGED CARE
Authorized Official - Prefix:
Authorized Official - First Name:SHELLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:GAST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-272-5165
Mailing Address - Street 1:PO BOX 776708 RETAIL RX - NBH
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-6708
Mailing Address - Country:US
Mailing Address - Phone:502-446-8800
Mailing Address - Fax:502-629-3805
Practice Address - Street 1:4960 NORTON HEALTHCARE BLVD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40241-2831
Practice Address - Country:US
Practice Address - Phone:502-446-8850
Practice Address - Fax:502-629-3805
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-21
Last Update Date:2021-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYP076033336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100318090Medicaid
2145165OtherPK