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LAKE CUMBERLAND PHARMACY #2
NPI 1912201906
Pharmacy - Community/Retail Pharmacy in Russell Springs, KY

Active since January 05, 2011
124 DOWELL RD, RUSSELL SPRINGS, KY 42642(270) 866-2686(270) 866-6566 Get Directions Write a Review

NPPES record last updated: October 7, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Oct 7, 2022, Feb 21, 2017 (2 updates tracked since 2017).

About Lake Cumberland Pharmacy #2 NPPES

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

LAKE CUMBERLAND PHARMACY #2 (NPI 1912201906) is a healthcare organization registered as a community/retail pharmacy in Russell Springs, Kentucky and active in the NPI registry since January 2011. The organization lists Jonathan Grider, Managing Member, as its authorized official.

NPPES Registry Identity

NPI1912201906
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameLAKE CUMBERLAND PHARMACY LLC
Location Address124 DOWELL RDRussell Springs, KY 42642-4278
Mailing AddressPo Box 72Russell Springs, KY 42642-0072 · (270) 866-2686
Phone(270) 866-2686
Fax(270) 866-6566
Organization SubpartNo
Authorized OfficialJonathan GriderManaging Member · (270) 858-6400
Enumeration DateJanuary 5, 2011
Last NPPES UpdateOctober 7, 20222 updates tracked since enumeration
NPPES CertifiedOctober 7, 2022
✔ NPI 1912201906 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers
Taxonomy Code3336C0003X
License✔ Licensed in KY · P07440
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 Supplies · Parenteral & Enteral NutritionTaxonomy 332BP3500X
Also ListedPharmacyTaxonomy 333600000X
124 DOWELL RD, Russell Springs, KY 42642
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Other Names 1

Doing Business AsLake Cumberland Pharmacy #2

Other Identifiers 2

Other2128898Pk
Medicaid7100171840KY

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter from Arizona Complete Health and more.Insurance ›

Medical Equipment Supplier Medicare DMEPOS 6

Medicare supplier enrollment and the product categories Lake Cumberland Pharmacy #2 carries, from the Medicare DMEPOS supplier directory.

Lake Cumberland Pharmacy #2

DMEPOS supplier · Russell Springs, KYOperated by Lake Cumberland Pharmacy LLC
✔

Accepts Medicare assignment

Lake Cumberland Pharmacy #2 agrees to accept the Medicare-approved amount as full payment for covered equipment and supplies. Medicare patients are not billed beyond the standard deductible and coinsurance.

PTAN (Medicare Supplier Number)20477267
Medicare Participant SinceAugust 1, 2016
Supplier Location124 Dowell RdRussell Springs, KY 42642
Phone(270) 866-2686
Supplier Specialties
Pharmacy

Medicare Product Categories

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
Infusion Drugs
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
Product categories are from the Medicare DMEPOS supplier directory. Contact the supplier to confirm current availability of specific items.

Other Providers at the Same Location NPPES 10

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

RUSSELL COUNTY HOSPITAL
Clinic/Center (Rural Health)
124 DOWELL RD
RUSSELL SPRINGS, KY 42642
Russell County (270) 866-4141
DR. RICHARD STAYTON MILES MD
Family Medicine
124 DOWELL RD
RUSSELL SPRINGS, KY 42642
Russell County (270) 866-2440
ERIC B GRIDER
Pharmacist
124 DOWELL RD
RUSSELL SPRINGS, KY 42642
Russell County (270) 866-2686
EPHRAIM MCDOWELL HEALTH RESOURCE, INC
Internal Medicine (Cardiovascular Disease)
124 DOWELL RD
RUSSELL SPRINGS, KY 42642
Russell County (859) 239-5870
JOHN KILGALLIN M.D.
Family Medicine
124 DOWELL RD
RUSSELL SPRINGS, KY 42642
Russell County (270) 866-3161
RICHARD S MILES PSC
Family Medicine
124 DOWELL RD
RUSSELL SPGS, KY 42642
Russell County (270) 866-2440
RUSSELL COUNTY HOSPITAL
Clinical Medical Laboratory
124 DOWELL RD
RUSSELL SPRINGS, KY 42642
Russell County (270) 866-2016
MONICA TAYLOR APRN, PMHNP-BC
Nurse Practitioner (Psychiatric/Mental Health)
124 DOWELL RD
RUSSELL SPRINGS, KY 42642
Russell County (270) 866-2440

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 Lake Cumberland Pharmacy LLC's NPI number?

The NPI number for Lake Cumberland Pharmacy LLC is 1912201906. It was assigned to this organization in the NPPES registry on January 5, 2011. The provider is doing business as Lake Cumberland Pharmacy #2.

Where is Lake Cumberland Pharmacy LLC located?

Lake Cumberland Pharmacy LLC is located at 124 Dowell Rd, Russell Springs, KY 42642. The listed phone number is (270) 866-2686.

What is Lake Cumberland Pharmacy LLC's specialty?

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

Does Lake Cumberland Pharmacy LLC accept Medicare assignment for medical equipment?

Yes. As a Medicare medical equipment supplier, Lake Cumberland Pharmacy #2 accepts Medicare assignment: the supplier accepts the Medicare-approved amount as payment in full for covered equipment and supplies.

What insurance does Lake Cumberland Pharmacy LLC accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter Health of Delaware, Ambetter from Absolute Total Care and Ambetter from Arizona Complete Health and 48 other insurers list Lake Cumberland Pharmacy 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 Lake Cumberland Pharmacy LLC was last updated on October 7, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.