Provider Demographics
NPI:1891099669
Name:SAV-RITE PHARMACY LLC
Entity Type:Organization
Organization Name:SAV-RITE PHARMACY LLC
Other - Org Name:SAV-RITE FAMILY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WARREN
Authorized Official - Middle Name:
Authorized Official - Last Name:GARDNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:606-528-7770
Mailing Address - Street 1:1150 MASTER ST
Mailing Address - Street 2:
Mailing Address - City:CORBIN
Mailing Address - State:KY
Mailing Address - Zip Code:40701-2563
Mailing Address - Country:US
Mailing Address - Phone:606-528-7770
Mailing Address - Fax:606-528-7267
Practice Address - Street 1:1150 MASTER ST
Practice Address - Street 2:
Practice Address - City:CORBIN
Practice Address - State:KY
Practice Address - Zip Code:40701-2563
Practice Address - Country:US
Practice Address - Phone:606-528-7770
Practice Address - Fax:606-528-7267
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-07
Last Update Date:2020-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 333600000X
KYP074293336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100150120Medicaid
KY7100209050Medicaid
2128268OtherPK
2128268OtherPK