CLINIC PHARMACY MADISONVILLE
NPI 1578066072
Pharmacy - Community/Retail Pharmacy in Madisonville, KY

Q: What is the provider's specialty?

The provider's specialty is Pharmacy with taxonomy code 3336C0003X and a focus in Community/Retail Pharmacy.

Active since March 12, 2018CLIA 18D2197286 · Waiver

510 RUBY DR, MADISONVILLE, KY 42431(270) 754-4300(270) 754-9881 Get Directions Write a Review

NPPES record last updated: March 12, 2018. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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About Clinic Pharmacy Madisonville NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CLINIC PHARMACY MADISONVILLE (NPI 1578066072) is a healthcare organization registered as a community/retail pharmacy in Madisonville, Kentucky and active in the NPI registry since March 2018. The organization holds a CLIA Waiver certificate valid through October 22, 2026 and lists Theresa Powers Elliott, Cpa, as its authorized official.

NPPES Registry Identity

NPI1578066072

Entity TypeOrganization

Primary Taxonomy3336C0003X

Legal Business NameCENTRAL CITY CLINIC PHARMACY, INC.

Location Address510 RUBY DRMadisonville, KY 42431-2168

Mailing Address203 N 2nd StCentral City, KY 42330-1205 · (270) 754-4300 · Fax (270) 754-9881

Phone(270) 754-4300

Fax(270) 754-9881

Organization SubpartNo

Authorized OfficialTheresa Powers ElliottCpa · (270) 684-3414

Enumeration DateMarch 12, 2018

✔ NPI 1578066072 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers

Taxonomy Code3336C0003X

License✔ Licensed in KY · P07870

Definition

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.

510 RUBY DR, Madisonville, KY 42431

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Other Names 1

Doing Business AsClinic Pharmacy Madisonville

Other Identifiers 1

OtherP07870KY · Pharmacy Permit

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 18D2197286

Central City Clinic Pharmacy · Central City, KY

Active · expires Oct 22, 2026

CLIA Number18D2197286

Laboratory TypePharmacy

Certificate Effective DateOctober 23, 2024

Certificate Expiration DateOctober 22, 2026

Laboratory DirectorMr. Evan M. Sweeney

Laboratory Phone(270) 754-4300

Laboratory LocationCentral City Clinic Pharmacy203 N 2nd Street, Central City, KY 42330

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 17

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

BRADLY C. NEWCOM M.D.

Pain Medicine (Pain Medicine)