KILGORE EXPRESS PHARMACY (KILGORE EXPRESS PHARMACY INC) NPI 1609974633

Pharmacy (Community/Retail Pharmacy) in Fort Payne, AL

NPI 1609974633 Organization Pharmacy Community/Retail Pharmacy Medicare Supplier Accepts Medicare Approved Payment CLIA Number 01D2195531 CLIA Certificate of Waiver

NPI Profile for KILGORE EXPRESS PHARMACY (KILGORE EXPRESS PHARMACY INC)

Kilgore Express Pharmacy (kilgore Express Pharmacy Inc) is a provider established in Fort Payne, Alabama specializing in pharmacy (community/retail pharmacy) . The NPI number of Kilgore Express Pharmacy (kilgore Express Pharmacy Inc) is 1609974633 and was assigned on September 2006. The practitioner's primary taxonomy code is 3336C0003X with license number 112680 (AL). The provider is registered as an organization and their NPI record was last updated 3 years ago. The provider's is doing business as Kilgore Express Pharmacy. The authorized official of this NPI record is Lotha Kilgore Rph. (Owner)

Kilgore Express Pharmacy is a medicare supplier with PTAN 5124900002 who accepts Medicare assignment for all durable medical equipment and supplies. The provider accepts the Medicare allowable as payment in full.The supplier carries the following product categories: Epoetin or Immunosuppressive Drugs or Nebulizer Drugs or Oral Anticancer Drugs or Oral Antiemetic Drugs or Commodes, Urinals, Bedpans or Blood Glucose Monitors/Supplies (Non-Mail Order) or Heat & Cold Applications or (TENS) Transcutaneous Electrical Nerve Stimulators and/or Supplies or Canes and/or Crutches or Walkers or Wheelchairs (Standard Manual) or Wheelchairs (Standard Manual Related Accessories) or Wheelchairs (Complex Rehabilitative Manual) or Wheelchairs (Complex Rehab Manual Rel Accessories) or Wheelchairs (Complex Rehab Power Rel Accessories) or Wheelchair Seating/Cushions or Orthoses: Off-The-Shelf or Ostomy Supplies or Urological Supplies or Nebulizer Equipment and/or Supplies or Respiratory Assist Devices or Respiratory Suction Pumps or Surgical Dressings.

The CLIA number of Kilgore Express Pharmacy is 01D2195531 registered as a "pharmacy" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to Kilgore Express Pharmacy to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

NPI

1609974633

Provider NameKILGORE EXPRESS PHARMACY (KILGORE EXPRESS PHARMACY INC)
Provider Location Address103 GREENHILL BLVD NW FORT PAYNE, AL 35967
Provider Mailing AddressPO BOX 680905 FORT PAYNE, AL 35968
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Other Organization NameKILGORE EXPRESS PHARMACY
Other Name TypeDoing Business As (3)
Enumeration Date09-21-2006
Last Update Date12-24-2019


Primary Taxonomy

Taxonomy Code3336C0003X
ClassificationPharmacy
TypeSuppliers
SpecializationCommunity/Retail Pharmacy
License No.112680
License StateAL
Taxonomy DescriptionA 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.

Business Address

KILGORE EXPRESS PHARMACY
103 GREENHILL BLVD NW
FORT PAYNE, AL
ZIP 35967
Phone: (256) 845-6640
Fax: (256) 845-9796

Get Directions


Mailing Address

KILGORE EXPRESS PHARMACY
PO BOX 680905
FORT PAYNE, AL
ZIP 35968
Phone: (256) 845-6640
Fax: (256) 845-9796



Authorized Official

Authorized Official Name LOTHA KILGORE RPH.
Authorized Official TitleOWNER
Authorized Official Phone(256) 845-6640

Medical Equipment Supplier

The provider carries the following medical supplies product categories:

PTAN5124900002
Accepts Medicare AssignmentYES
Specialities ListCertified Other, Pharmacy.
Supplies List
  • Epoetin - Epoetin is a man-made version of human erythropoietin (EPO)
  • Immunosuppressive Drugs - Immunosuppressive drugs require dosage, frequency, and route of administration to prevent or treat the rejection of an organ transplant
  • Nebulizer Drugs - Albuterol, levalbuterol, and metaproterenol are all short-acting bronchodilators with beta-adrenergic stimulatory effect
  • Oral Anticancer Drugs - FDA anticancer drugs
  • Oral Antiemetic Drugs - FDA antiemetic drugs
  • Commodes, Urinals, Bedpans - Raised toilets, Drop-arm commodes, Folding commodes, Plastic urinals, Plastic bedpans, Disposable urinals
  • Blood Glucose Monitors/Supplies (Non-Mail Order) - Home blood glucose monitors including lancets, reagent strips, and other supplies necessary for the proper functioning of the device
  • Heat & Cold Applications - Heat therapy, Cold therapy, Heating pads
  • (TENS) Transcutaneous Electrical Nerve Stimulators and/or Supplies - Transcutaneous Electrical Nerve Stimulation (TENS) for the relief of acute post-operative pain
  • Canes and/or Crutches - Standard Canes, Quad Canes, Offset Canes, Standard Crutches, Forearm Crutches
  • Walkers - Standard Walkers, Wheeled Walkers, Folding Walker
  • Wheelchairs (Standard Manual) - Standard wheelchairs, transport wheelchairs, heavy duty wheelchairs
  • Wheelchairs (Standard Manual Related Accessories) - Accessories for standard wheelchairs, transport wheelchairs, heavy duty wheelchairs
  • Wheelchairs (Complex Rehabilitative Manual) - Complex rehabilitative manual wheelchairs
  • Wheelchairs (Complex Rehab Manual Rel Accessories) - Complex rehabilitative manual wheelchairs
  • Wheelchairs (Complex Rehab Power Rel Accessories) - Complex rehabilitative power wheelchairs
  • Wheelchair Seating/Cushions - Wheelchair seat cushions, Wheelchair bank cushions, Wheelchair padded armrests
  • Orthoses: Off-The-Shelf - Met pads, Heel pads, Heel spur pads
  • Ostomy Supplies - Pouches, Paste, Powder, Barrier wipes
  • Urological Supplies - Catheters, Urinary collection devices
  • Nebulizer Equipment and/or Supplies - Nebulizers, Atomizers, Filters
  • Respiratory Assist Devices -
  • Respiratory Suction Pumps - Portable suction pumps, Stationary suction pumps, Canisters
  • Surgical Dressings - Gauze, Elastic bandages, Adhesive tape
Competitive BiddingNO

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for the NPI number 1609974633 is:

CLIA Number01D2195531
Facility TypePHARMACY
Certificate TypeCertificate of Waiver

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
1333600000XSuppliersPharmacyNo

Taxonomy Description: a 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.

23336S0011XSuppliersPharmacySpecialty PharmacyNo

Taxonomy Description: a pharmacy that dispenses generally low volume and high cost medicinal preparations to patients who are undergoing intensive therapies for illnesses that are generally chronic, complex and potentially life threatening. Often these therapies require specialized delivery and administration.

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 Identifier Issuer
1995543OTHER (01)PK
009935092MEDICAID (05)AL
100003635MEDICAID (05)AL

NPI Validation Check Digit Calculation


The following table explains step by step the NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1609974633
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2609187866
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 6 + 0 + 9 + 1 + 8 + 7 + 8 + 6 + 6 + 24 = 77
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
80 - 77 = 33

The NPI number 1609974633 is valid because the calculated check digit 3 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the same location


The following 2 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1083253876 LOTHA LEE KILGORE
Individual
Pharmacist103 GREENHILL BLVD NW
FORT PAYNE, AL 35967
(256) 845-6640
1326713744DR. RYAN GREGORY OAKLEY PHARM.D., MPH
Individual
Pharmacist103 GREENHILL BLVD NW
FORT PAYNE, AL 35967
(256) 845-6640

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
Kilgore Express Pharmacy is registered as an entity type code: 2. The entity type code describes 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.