Provider Demographics
NPI:1942236112
Name:WHITAKER PHARMACARE, INC.
Entity Type:Organization
Organization Name:WHITAKER PHARMACARE, INC.
Other - Org Name:WHITAKER PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/RPH
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITAKER
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:859-498-3141
Mailing Address - Street 1:570 INDIAN MOUND DRIVE
Mailing Address - Street 2:
Mailing Address - City:MT. STERLING
Mailing Address - State:KY
Mailing Address - Zip Code:40353
Mailing Address - Country:US
Mailing Address - Phone:859-498-3141
Mailing Address - Fax:859-498-2434
Practice Address - Street 1:570 INDIAN MOUND DRIVE
Practice Address - Street 2:
Practice Address - City:MOUNT STERLING
Practice Address - State:KY
Practice Address - Zip Code:40353
Practice Address - Country:US
Practice Address - Phone:859-498-3141
Practice Address - Fax:859-498-2434
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-22
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X
KYP06722333600000X, 3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
1827154OtherNCPDP
KY54002878Medicaid
KY54002878Medicaid
BW7541130OtherFEDERAL DEA