Provider Demographics
NPI:1154420271
Name:HOUCHENS EXPRESS PHARMACY LLC
Entity type:Organization
Organization Name:HOUCHENS EXPRESS PHARMACY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:E
Authorized Official - Last Name:SHELDON
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:270-392-0821
Mailing Address - Street 1:212 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:KY
Mailing Address - Zip Code:42134
Mailing Address - Country:US
Mailing Address - Phone:270-586-4471
Mailing Address - Fax:270-586-8595
Practice Address - Street 1:212 S MAIN ST
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:KY
Practice Address - Zip Code:42134
Practice Address - Country:US
Practice Address - Phone:270-586-4471
Practice Address - Fax:270-586-8595
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HOUCHENS EXPRESS PHARMACY, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-09-22
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYP07369332B00000X, 3336C0003X, 3336C0004X
KYP00469333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY1804726OtherNCPDP
KY7100218100Medicaid
KYP07369OtherPHARMACY PERMIT
KYP07369OtherPHARMACY PERMIT
KY6198680003Medicare NSC