Provider Demographics
NPI:1629234703
Name:NORTON PHARMACIES, PLLC
Entity Type:Organization
Organization Name:NORTON PHARMACIES, PLLC
Other - Org Name:NORTON SPECIALTY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SENIOR CREDENTIALING COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:
Authorized Official - Last Name:HILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-272-5165
Mailing Address - Street 1:PO BOX 776708
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:502-559-1310
Mailing Address - Fax:502-559-1305
Practice Address - Street 1:2700 STANLEY GAULT PKWY STE 103
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40223-5133
Practice Address - Country:US
Practice Address - Phone:502-559-1310
Practice Address - Fax:502-559-1305
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-29
Last Update Date:2021-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYP072753336S0011X
IN64001263A3336S0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100064300Medicaid
2116752OtherPK
2116752OtherPK