Provider Demographics
NPI:1477601391
Name:HEALTH FIRST PHARMACY PSC
Entity Type:Organization
Organization Name:HEALTH FIRST PHARMACY PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT COOWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:WESLEY
Authorized Official - Middle Name:KEVIN
Authorized Official - Last Name:JENKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-299-2467
Mailing Address - Street 1:111 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:GREENSBURG
Mailing Address - State:KY
Mailing Address - Zip Code:42743-1563
Mailing Address - Country:US
Mailing Address - Phone:270-299-2467
Mailing Address - Fax:
Practice Address - Street 1:111 S MAIN ST
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:KY
Practice Address - Zip Code:42743-1563
Practice Address - Country:US
Practice Address - Phone:270-299-2467
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-08
Last Update Date:2012-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYP070143336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY54009329Medicaid
KY1828916OtherNCPDP
KY5360010001Medicare ID - Type Unspecified