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PRINCETON DRUG STORE
NPI 1639273691
Pharmacy - Community/Retail Pharmacy in Princeton, KY

Active since September 12, 2006CLIA 18D2164112 · Waiver
103 W MAIN ST, PRINCETON, KY 42445(270) 365-5585(270) 365-0559 Get Directions Write a Review

NPPES record last updated: April 16, 2023. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Apr 16, 2023, Apr 1, 2019, Jan 16, 2019 and 3 more (6 updates tracked since 2016).

About Princeton Drug Store NPPES

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

PRINCETON DRUG STORE (NPI 1639273691) is a healthcare organization registered as a community/retail pharmacy in Princeton, Kentucky and active in the NPI registry since September 2006. The organization holds a CLIA Waiver certificate valid through March 27, 2027 and lists Jimmy L Tucker, Owner, Ceo, President, as its authorized official.

NPPES Registry Identity

NPI1639273691
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NamePDC, LLC
Location Address103 W MAIN STPrinceton, KY 42445-1546
Mailing Address103 W Main StPrinceton, KY 42445 · (270) 365-5585 · Fax (270) 365-0559
Phone(270) 365-5585
Fax(270) 365-0559
Organization SubpartNo
Authorized OfficialJimmy L TuckerOwner, Ceo, President · (270) 365-5585
Enumeration DateSeptember 12, 2006
Last NPPES UpdateApril 16, 20236 updates tracked since enumeration
NPPES CertifiedApril 16, 2023
✔ NPI 1639273691 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers
Taxonomy Code3336C0003X
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.
Also ListedDurable Medical Equipment & Medical SuppliesTaxonomy 332B00000X
Also ListedPharmacyTaxonomy 333600000X
103 W MAIN ST, Princeton, KY 42445
Open in Google Maps ↗

Other Names 1

Doing Business AsPrinceton Drug Store

Other Identifiers 1

Medicaid7100544640KY

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Anthem Blue Cross and Blue Shield, Antidote Health Plan of Arizona, Inc. and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and revalidation status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Princeton Drug Store is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by February 28, 2027

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date
StateKentuckyEnrollment IDO20180615001909DME · PharmacyDue dateFebruary 28, 2027
Source: CMS Revalidation Due Date List, October 2026 release.

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 18D2164112

Pdc, LLC Dba Princeton Drug Store · Princeton, KY
Active · expires Mar 27, 2027
CLIA Number18D2164112
Laboratory TypePharmacy
Certificate Effective DateMarch 28, 2025
Certificate Expiration DateMarch 27, 2027
Laboratory DirectorDr. Heath Adams
Laboratory Phone(270) 365-5585
Laboratory LocationPdc, LLC Dba Princeton Drug Store103 West Main Street, Princeton, KY 42445
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Administration of influenza virus vaccine G0008
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
39 services39 patients
Influenza vaccine split virus, preservative free 90662
The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.
24 services24 patients
Influenza vaccine, inactivated 90653
The Influenza vaccine, inactivated, is a shot given to protect against the flu. It contains killed virus particles that help your body build immunity to the flu. It's recommended annually to keep your protection up-to-date. It's safe for ages 6 months and up.
12 services12 patients

Other Providers at the Same Location NPPES 3

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

MR. RODNEY PIERCE WHITTINGTON R.PH.
Pharmacist
103 W MAIN ST
PRINCETON, KY 42445
Caldwell County (270) 365-5585
LANCE HOWARD MOORE PHARMD
Pharmacist
103 W MAIN ST
PRINCETON, KY 42445
Caldwell County (270) 365-5585
PDC, LLC
Pharmacy (Long Term Care Pharmacy)
103 W MAIN ST
PRINCETON, KY 42445
Caldwell County (270) 365-5585

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Pdc, LLC's NPI number?

The NPI number for Pdc, LLC is 1639273691. It was assigned to this organization in the NPPES registry on September 12, 2006. The provider is doing business as Princeton Drug Store.

Where is Pdc, LLC located?

Pdc, LLC is located at 103 W Main St, Princeton, KY 42445. The listed phone number is (270) 365-5585.

What is Pdc, LLC's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Community/Retail Pharmacy, with taxonomy code 3336C0003X.

Is Pdc, LLC enrolled in Medicare?

Yes. Pdc, LLC is registered in the Medicare PECOS enrollment system.

When is Pdc, LLC's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare DME enrollment for this organization (Kentucky, Pharmacy) is due for revalidation by February 28, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

Does Pdc, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 18D2164112) is associated with this NPI, valid through March 27, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Pdc, LLC accept?

Health plans from Alliant Health Plans, Inc., Anthem Blue Cross and Blue Shield, Antidote Health Plan of Arizona, Inc., Antidote Health Plan of Ohio, Inc. and Avera Health Plans and 26 other insurers list Pdc, LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Pdc, LLC was last updated on April 16, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.