Lake Cumberland Pharmacy LLC
NPI #1912217589 in Russell Springs, Kentucky
Provider Information
- NPI Number
- 1912217589
- Entity Type
- Organization
- Organization Name
- Lake Cumberland Pharmacy LLC
- Primary Specialty
- Pharmacy - Community/Retail Pharmacy
- Enumeration Date
- Oct 18, 2010
- Last Updated
- Nov 14, 2024
Practice Location
- Address
- 2431C LAKEWAY DR
- City
- Russell Springs
- State
- Kentucky
- ZIP Code
- 42642-4510
- Phone
- (270) 858-6400
Authorized Official
- Name
- JONATHAN GIDER, PHARMD
- Title
- PHARMACIST-IN-CHARGE
- Phone
- (270) 585-2221
Specialties & Taxonomy Codes
| Specialty |
|---|
| Pharmacy |
| Pharmacy - Home Infusion Therapy Pharmacy — Home Infusion Therapy Pharmacy |
| Durable Medical Equipment & Medical Supplies - Parenteral & Enteral Nutrition — Parenteral & Enteral Nutrition |
| Pharmacy - Community/Retail Pharmacy — Community/Retail Pharmacy |
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