Provider Demographics
NPI:1013069582
Name:INSTITUTIONAL PHARMACY INC
Entity type:Organization
Organization Name:INSTITUTIONAL PHARMACY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PIC
Authorized Official - Prefix:
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:HILL
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:606-528-4380
Mailing Address - Street 1:PO BOX 1450
Mailing Address - Street 2:
Mailing Address - City:CORBIN
Mailing Address - State:KY
Mailing Address - Zip Code:40702-1450
Mailing Address - Country:US
Mailing Address - Phone:606-528-9600
Mailing Address - Fax:606-528-9600
Practice Address - Street 1:108 E 6TH ST
Practice Address - Street 2:
Practice Address - City:CORBIN
Practice Address - State:KY
Practice Address - Zip Code:40701-1422
Practice Address - Country:US
Practice Address - Phone:606-528-4380
Practice Address - Fax:606-526-7258
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-17
Last Update Date:2015-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3336I0012X
KYP067913336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No3336I0012XSuppliersPharmacyInstitutional Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY5402514300Medicaid
2031682OtherPK
4711920001Medicare NSC