OPTIMUM WELLNESS CENTER NPI 1003446162

Pharmacy in Paintsville, KY

Organization Pharmacy

About OPTIMUM WELLNESS CENTER

Optimum Wellness Center is a provider established in Paintsville, Kentucky specializing in pharmacy. The NPI number of Optimum Wellness Center is 1003446162 and was assigned on January 2020. The practitioner's primary taxonomy code is 333600000X. The provider is registered as an organization and their NPI record was last updated June 2020. The authorized official of this NPI record is Mr. Matthew Sammons (Owner)

NPI

1003446162

Provider NameOPTIMUM WELLNESS CENTER
Provider Location Address716 BROADWAY ST PAINTSVILLE, KY 41240
Provider Mailing Address716 BROADWAY ST PAINTSVILLE, KY 41240
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Enumeration Date01-17-2020
Last Update Date06-20-2020

Primary Taxonomy

Taxonomy Code333600000X
ClassificationPharmacy
TypeSuppliers
Taxonomy DescriptionA facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.

Business Address

OPTIMUM WELLNESS CENTER
716 BROADWAY ST
PAINTSVILLE, KY
ZIP 41240
Phone: (606) 792-2330

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Mailing Address

OPTIMUM WELLNESS CENTER
716 BROADWAY ST
PAINTSVILLE, KY
ZIP 41240
Phone: (606) 220-2553

Authorized Official

Authorized Official NameMR. MATTHEW SAMMONS
Authorized Official TitleOWNER
Authorized Official Phone(606) 220-2553

Secondary Taxonomies


The secondary taxonomy codes define the provider type, classification, and specialization. For individual NPIs the license data is associated to each taxonomy code.

No. Taxonomy Code Type Classification Specialization License No. State Primary
13336C0003XSuppliersPharmacyCommunity/Retail PharmacyNo

Taxonomy Description: a pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
7100648130MEDICAID (05)KY

Other Providers at the same location


The following provider is registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1508156282 MATTHEW SAMMONS PHARM D.
Individual
Pharmacist716 BROADWAY ST
PAINTSVILLE, KY 41240
(606) 220-2553

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.