Provider Demographics
NPI:1639105364
Name:MORGANS MEDICINE PLLC
Entity Type:Organization
Organization Name:MORGANS MEDICINE PLLC
Other - Org Name:MORGAN'S MEDICINE, PLLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:MORGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:606-387-8875
Mailing Address - Street 1:PO BOX 220
Mailing Address - Street 2:
Mailing Address - City:BURKESVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42717-0220
Mailing Address - Country:US
Mailing Address - Phone:270-864-2222
Mailing Address - Fax:270-864-2228
Practice Address - Street 1:360 KEEN ST STE 100
Practice Address - Street 2:
Practice Address - City:BURKESVILLE
Practice Address - State:KY
Practice Address - Zip Code:42717-7916
Practice Address - Country:US
Practice Address - Phone:270-864-2222
Practice Address - Fax:270-864-2228
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-24
Last Update Date:2015-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
KYP070623336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY54010970Medicaid
2034583OtherPK
5616590001Medicare NSC
KY5616590001Medicare NSC