ARCHER CLINIC PHARMACY – NPI #1538174172
Pharmacy

A pharmacy that specializes in the preparation of components into a drug preparation as the result of a Practitioner's Prescription Drug Order or initiative based on the Practitioner/Patient/Pharmacist relationship in the course of professional practice. A compounding pharmacy utilizes specialized equipment and specially designed facilities necessary to meet the legal and quality requirements of its scope of compounding practice.

ARCHER CLINIC PHARMACY is a pharmacy located in PRESTONSBURG, KY. NPPES has assigned the NPI number 1538174172 to ARCHER CLINIC PHARMACY on July 30, 2006. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “ARCHER CLINIC PHARMACY” is a dba name, the actual legal business name for this organization is PRESTONSBURG PHARMACIST GROUP LLC. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 3336C0004X from the Health Care Provider Taxonomy code set, which is classified as Pharmacy, specializing in Compounding Pharmacy

The NPI profile was previously updated about 8 years ago on Sep 19, 2018. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for ARCHER CLINIC PHARMACY below.

NPI Profile for
PRESTONSBURG PHARMACIST GROUP LLC

NPI Number
1538174172
Enumeration Date

(about 20 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
PRESTONSBURG PHARMACIST GROUP LLC
Doing Business As (dba): ARCHER CLINIC PHARMACY
Primary location
400 UNIVERSITY DR
SUITE 100
PRESTONSBURG, KY 41653
Phone: (606) 886-1202 Fax: (606) 886-1346
Mailing address
1002 SOUTH BROADWAY
SUITE 7
GEORGETOWN, KY 40324
Phone: (502) 370-4336 Fax: (502) 370-4352
Organization Subpart
Yes - ARCHER CLINIC PHARMACY is subpart of another organization.
Authorized Official
JUSTIN BELL
PRESIDENT
Phone: (502) 370-4336
Updated
Identifiers

Identifiers for ARCHER CLINIC PHARMACY

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
OTHERPK2030532
MEDICAIDKY54019179
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
3336C0004X
- Pharmacy / Compounding Pharmacy (Primary)
3336C0003X
- Pharmacy / Community/Retail Pharmacy
KY P01662
333600000X
- Pharmacy

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.