Provider Demographics
NPI:1336728450
Name:UNIVERSITY OF KENTUCKY
Entity Type:Organization
Organization Name:UNIVERSITY OF KENTUCKY
Other - Org Name:UK BLUEGRASS CLINIC PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF OF PAYER ADMINISTRATION
Authorized Official - Prefix:
Authorized Official - First Name:ELAINE
Authorized Official - Middle Name:DEBORD
Authorized Official - Last Name:YOUNCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-257-9521
Mailing Address - Street 1:2317 ALUMNI PARK PLZ STE 150
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40517-4291
Mailing Address - Country:US
Mailing Address - Phone:859-257-9521
Mailing Address - Fax:
Practice Address - Street 1:3101 BEAUMONT CENTRE CIR RM 135
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40513-1961
Practice Address - Country:US
Practice Address - Phone:859-562-0220
Practice Address - Fax:859-257-3828
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-06
Last Update Date:2022-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336C0002XSuppliersPharmacyClinic Pharmacy
No3336M0002XSuppliersPharmacyMail Order Pharmacy