Provider Demographics
NPI:1851372197
Name:SUTTON DRUGS OF LACENTER INC
Entity Type:Organization
Organization Name:SUTTON DRUGS OF LACENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:L
Authorized Official - Last Name:SUTTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-665-5192
Mailing Address - Street 1:PO BOX 179
Mailing Address - Street 2:
Mailing Address - City:LA CENTER
Mailing Address - State:KY
Mailing Address - Zip Code:42056-0179
Mailing Address - Country:US
Mailing Address - Phone:270-665-5192
Mailing Address - Fax:270-665-9296
Practice Address - Street 1:234 BROADWAY
Practice Address - Street 2:
Practice Address - City:LA CENTER
Practice Address - State:KY
Practice Address - Zip Code:42056
Practice Address - Country:US
Practice Address - Phone:270-665-5192
Practice Address - Fax:270-665-9296
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY54014162Medicaid
KY54014162Medicaid