Provider Demographics
NPI:1215126735
Name:FLEMING PHARMACIST GROUP INC
Entity type:Organization
Organization Name:FLEMING PHARMACIST GROUP INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:CRUMP
Authorized Official - Last Name:FRONK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:606-845-3421
Mailing Address - Street 1:118 CLARK ST
Mailing Address - Street 2:
Mailing Address - City:FLEMINGSBURG
Mailing Address - State:KY
Mailing Address - Zip Code:41041-1207
Mailing Address - Country:US
Mailing Address - Phone:606-845-3421
Mailing Address - Fax:
Practice Address - Street 1:118 CLARK ST
Practice Address - Street 2:
Practice Address - City:FLEMINGSBURG
Practice Address - State:KY
Practice Address - Zip Code:41041-1207
Practice Address - Country:US
Practice Address - Phone:606-845-3421
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-22
Last Update Date:2018-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYPO2216332B00000X
KYP02216332BP3500X, 3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYFLU0326OtherMASS IMMUNIZATION
KY7100208410Medicaid
KY90050352Medicaid
KY90050352Medicaid