Provider Demographics
NPI:1457693822
Name:MORGANS PROFESSIONAL PHARMACY LLC
Entity Type:Organization
Organization Name:MORGANS PROFESSIONAL PHARMACY LLC
Other - Org Name:MORGAN'S PROFESSIONAL PHARMACY, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CO-OWNER/PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:MORGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:606-599-8276
Mailing Address - Street 1:280 RICHMOND RD
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:KY
Mailing Address - Zip Code:40962-1209
Mailing Address - Country:US
Mailing Address - Phone:606-599-8276
Mailing Address - Fax:
Practice Address - Street 1:280 RICHMOND RD
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:KY
Practice Address - Zip Code:40962-1209
Practice Address - Country:US
Practice Address - Phone:606-599-8276
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-22
Last Update Date:2013-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYP075623336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100246750Medicaid
2139918OtherPK