Provider Demographics
NPI:1437497104
Name:CCF PHARMACIST INTERVENTIONS & COMMUNITY CONSULTING SERVICES
Entity Type:Organization
Organization Name:CCF PHARMACIST INTERVENTIONS & COMMUNITY CONSULTING SERVICES
Other - Org Name:CCF PHARMACIST INTERVENTIONS & COMMUNITY CONSULTING SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CELESTE
Authorized Official - Middle Name:
Authorized Official - Last Name:FLICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-491-0900
Mailing Address - Street 1:1522 DIXIE HWY STE 123
Mailing Address - Street 2:CCF PI CCS
Mailing Address - City:PARK HILLS
Mailing Address - State:KY
Mailing Address - Zip Code:41011-2847
Mailing Address - Country:US
Mailing Address - Phone:859-491-0900
Mailing Address - Fax:859-491-4907
Practice Address - Street 1:1522 DIXIE HWY STE 123
Practice Address - Street 2:CCF PI CCS
Practice Address - City:PARK HILLS
Practice Address - State:KY
Practice Address - Zip Code:41011-2847
Practice Address - Country:US
Practice Address - Phone:859-491-0900
Practice Address - Fax:859-491-4907
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-30
Last Update Date:2013-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
KYP068743336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
1833525OtherNCPDP PROVIDER IDENTIFICATION NUMBER