Provider Demographics
NPI:1740394527
Name:SHEARER DRUG INC
Entity Type:Organization
Organization Name:SHEARER DRUG INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:KENT
Authorized Official - Middle Name:L
Authorized Official - Last Name:SHEARER
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMACIST
Authorized Official - Phone:606-387-6616
Mailing Address - Street 1:127 FOOTHILLS AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:KY
Mailing Address - Zip Code:42602-1037
Mailing Address - Country:US
Mailing Address - Phone:606-387-6616
Mailing Address - Fax:606-387-8006
Practice Address - Street 1:127 FOOTHILLS AVE STE 2
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:KY
Practice Address - Zip Code:42602-1037
Practice Address - Country:US
Practice Address - Phone:606-387-6616
Practice Address - Fax:606-387-8006
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-18
Last Update Date:2019-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X
KYP015013336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY54034558Medicaid
KY90040270Medicaid
KY54034558Medicaid