Provider Demographics
NPI:1750315784
Name:FAMILY DRUGS
Entity Type:Organization
Organization Name:FAMILY DRUGS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:ELLIOTT
Authorized Official - Last Name:AUSENBAUGH
Authorized Official - Suffix:JR
Authorized Official - Credentials:RPH
Authorized Official - Phone:270-797-3591
Mailing Address - Street 1:104 RAILROAD AVE
Mailing Address - Street 2:
Mailing Address - City:DAWSON SPRINGS
Mailing Address - State:KY
Mailing Address - Zip Code:42408
Mailing Address - Country:US
Mailing Address - Phone:270-797-3591
Mailing Address - Fax:270-797-3591
Practice Address - Street 1:104 RAILROAD AVE
Practice Address - Street 2:
Practice Address - City:DAWSON SPRINGS
Practice Address - State:KY
Practice Address - Zip Code:42408
Practice Address - Country:US
Practice Address - Phone:270-797-3591
Practice Address - Fax:270-797-3591
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 3336C0003X
KYP00345333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Not Answered333600000XSuppliersPharmacy
Not Answered3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY54012067Medicaid
1804409OtherNABP
KY90130543Medicare ID - Type Unspecified