Provider Demographics
NPI:1508287095
Name:ANDERSON PHARMACIST GROUP LLC
Entity Type:Organization
Organization Name:ANDERSON PHARMACIST GROUP LLC
Other - Org Name:ANDERSON APOTHECARY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:BARNETTE
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:859-498-0136
Mailing Address - Street 1:125 FOXGLOVE DR
Mailing Address - Street 2:
Mailing Address - City:MT STERLING
Mailing Address - State:KY
Mailing Address - Zip Code:40353-9735
Mailing Address - Country:US
Mailing Address - Phone:859-498-0136
Mailing Address - Fax:859-498-9037
Practice Address - Street 1:90 PLAZA DR
Practice Address - Street 2:
Practice Address - City:LAWRENCEBURG
Practice Address - State:KY
Practice Address - Zip Code:40342-9056
Practice Address - Country:US
Practice Address - Phone:859-498-0136
Practice Address - Fax:859-498-9037
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-30
Last Update Date:2018-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy