Provider Demographics
NPI:1518015569
Name:RITE VALUE PHARMACY LLC
Entity Type:Organization
Organization Name:RITE VALUE PHARMACY LLC
Other - Org Name:RITE VALUE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CLAYTON
Authorized Official - Middle Name:
Authorized Official - Last Name:WELLS
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:606-638-9627
Mailing Address - Street 1:PO BOX 297
Mailing Address - Street 2:
Mailing Address - City:LOUISA
Mailing Address - State:KY
Mailing Address - Zip Code:41230-0297
Mailing Address - Country:US
Mailing Address - Phone:606-638-9627
Mailing Address - Fax:606-638-4169
Practice Address - Street 1:2673 HIGHWAY 644 STE 1
Practice Address - Street 2:
Practice Address - City:LOUISA
Practice Address - State:KY
Practice Address - Zip Code:41230-5922
Practice Address - Country:US
Practice Address - Phone:606-638-9627
Practice Address - Fax:606-638-4169
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-08
Last Update Date:2016-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 333600000X, 3336C0004X
KYP070413336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810002982Medicaid
2034325OtherPK
KY54010442Medicaid
KY90011727Medicaid
KY54010442Medicaid