Provider Demographics
NPI:1790920783
Name:AMERICA'S ASSISTED LIVING PHARMACY
Entity Type:Organization
Organization Name:AMERICA'S ASSISTED LIVING PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ORMES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-442-4579
Mailing Address - Street 1:3524 PARK PLAZA RD
Mailing Address - Street 2:
Mailing Address - City:PADUCAH
Mailing Address - State:KY
Mailing Address - Zip Code:42001-8900
Mailing Address - Country:US
Mailing Address - Phone:270-442-4579
Mailing Address - Fax:
Practice Address - Street 1:3524 PARK PLAZA RD
Practice Address - Street 2:
Practice Address - City:PADUCAH
Practice Address - State:KY
Practice Address - Zip Code:42001-8900
Practice Address - Country:US
Practice Address - Phone:270-442-4579
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-05
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYP07316332B00000X
333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100060060Medicaid
KY1831002OtherNCPDP
KYP07316OtherSTATE
KYP07316OtherSTATE