Provider Demographics
NPI:1548336647
Name:B & K PHARMACY INC
Entity type:Organization
Organization Name:B & K PHARMACY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRES AND PHARM
Authorized Official - Prefix:
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:BARNETT
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:606-237-7430
Mailing Address - Street 1:412 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:S WILLIAMSON
Mailing Address - State:KY
Mailing Address - Zip Code:41503-4121
Mailing Address - Country:US
Mailing Address - Phone:606-237-7430
Mailing Address - Fax:606-237-7438
Practice Address - Street 1:412 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:S WILLIAMSON
Practice Address - State:KY
Practice Address - Zip Code:41503-4121
Practice Address - Country:US
Practice Address - Phone:606-237-7430
Practice Address - Fax:606-237-7438
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-28
Last Update Date:2014-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
KYP020803336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100185980Medicaid
WV0139281000Medicaid
2031362OtherPK
WV0139281000Medicaid