Provider Demographics
NPI:1730546409
Name:MED-SAVE LLC
Entity type:Organization
Organization Name:MED-SAVE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:JERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:BARNETTE
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:859-333-8462
Mailing Address - Street 1:102 PRINCE ROYAL DR STE 2
Mailing Address - Street 2:
Mailing Address - City:BEREA
Mailing Address - State:KY
Mailing Address - Zip Code:40403-1468
Mailing Address - Country:US
Mailing Address - Phone:859-985-7283
Mailing Address - Fax:859-985-0413
Practice Address - Street 1:102 PRINCE ROYAL DR STE 2
Practice Address - Street 2:
Practice Address - City:BEREA
Practice Address - State:KY
Practice Address - Zip Code:40403-1468
Practice Address - Country:US
Practice Address - Phone:859-985-7283
Practice Address - Fax:859-985-0413
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-26
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
KY077453336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2157432OtherPK
KY7100391870Medicaid
2157432OtherPK