Provider Demographics
NPI:1285440602
Name:WEST KNOX PHARMACY, LLC
Entity type:Organization
Organization Name:WEST KNOX PHARMACY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PIC
Authorized Official - Prefix:MS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:BAKER
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:606-258-1111
Mailing Address - Street 1:14161 N US HIGHWAY 25 E
Mailing Address - Street 2:
Mailing Address - City:CORBIN
Mailing Address - State:KY
Mailing Address - Zip Code:40701-6183
Mailing Address - Country:US
Mailing Address - Phone:606-258-1111
Mailing Address - Fax:606-258-0110
Practice Address - Street 1:14161 N US HIGHWAY 25 E
Practice Address - Street 2:
Practice Address - City:CORBIN
Practice Address - State:KY
Practice Address - Zip Code:40701-6183
Practice Address - Country:US
Practice Address - Phone:606-258-1111
Practice Address - Fax:606-258-0110
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-10
Last Update Date:2024-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy