Provider Demographics
NPI:1821030636
Name:PHARMACY ALTERNATIVES LLC
Entity type:Organization
Organization Name:PHARMACY ALTERNATIVES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PHARMACY
Authorized Official - Prefix:MR
Authorized Official - First Name:SCOTTY
Authorized Official - Middle Name:
Authorized Official - Last Name:SEARS
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:502-263-7274
Mailing Address - Street 1:11401 BLUEGRASS PARKWAY
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40299
Mailing Address - Country:US
Mailing Address - Phone:502-263-7274
Mailing Address - Fax:502-263-7882
Practice Address - Street 1:11401 BLUEGRASS PARKWAY
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40299
Practice Address - Country:US
Practice Address - Phone:502-263-7274
Practice Address - Fax:502-263-7882
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0215910003336L0003X
KYP070723336L0003X
IL054.017056333600000X
TN00000049503336L0003X
IN64001063A3336L0003X
AK11433336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2634733Medicaid
2034344OtherPK
KY54011085Medicaid
TN1526367Medicaid
IN200255990AMedicaid