Lake Cumberland Pharmacy Llc
Community/Retail Pharmacy
124 Dowell Rd, Russell Springs
Kentucky, 42642-4278
270-866-2686 270-866-6566
Lake Cumberland Pharmacy Llc is a Community/Retail Pharmacy in Russell Springs, Kentucky. It is located at 124 Dowell Rd, Russell Springs and it's customer support contact number is 270-866-2686. The authorized person of Lake Cumberland Pharmacy Llc is Jonathan Grider, PHARMD who is Managing Member of the pharmacy and his contact number is 270-858-6400. Active license number of Lake Cumberland Pharmacy Llc is P07440 for Community/Retail Pharmacy in Kentucky. Lake Cumberland Pharmacy Llc accepts medicare which means medicare covered patients will not be billed for any more than the Medicare deductible and coinsurance.
Lake Cumberland Pharmacy Llc is 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.
Pharmacy Details:
Lake Cumberland Pharmacy Llc type, location, contact phone number and fax are as below. Patients can directly walkin to the pharmacy or can call on the below given customer support phone number for enquiries.
| Name: | Lake Cumberland Pharmacy Llc |
| Type: | Community/Retail Pharmacy |
| Location: | 124 Dowell Rd, Russell Springs,
Kentucky, 42642-4278 |
| Phone: | 270-866-2686 |
| Fax: | 270-866-6566 |
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints of this pharmacy is as below. Person's position and contact details are also mentioned below.
| Name: | Jonathan Grider |
| Credentials: | PHARMD |
| Position: | Managing Member |
| Contact Number: | 270-858-6400 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details of given pharmacy are as mentioned below.
| NPI Number: | 1912201906 |
| NPI Enumeration Date: | 05 Jan, 2011 |
| NPI Last Update On: | 07 Oct, 2022 |
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Lake Cumberland Pharmacy Llc are as mentioned below.
| Specialization | License Number | State | Status | |
| Community/Retail Pharmacy | P07440 | Kentucky | Primary | |
| Parenteral & Enteral Nutrition | | | Secondary | |
| Pharmacy | | | Secondary | |
Other Medical Identifiers:
Other legacy medical identifiers of the pharmacy such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| 2128898 | Other | | Pk |
| 7100171840 | Medicaid | Kentucky | |
Medicare Enrollment:
Lake Cumberland Pharmacy Llc is enrolled in medicare and it's Pac Id, enrollment Id, registered name and type is as stated below.
| PAC ID: |
Enrollment ID: |
Org Name | Medicare Entity Type |
| 6800047739 | O20121127000115 | Lake Cumberland Pharmacy, Llc | DME SUPPLIER - PHARMACY |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | Po Box 72,
Russell Springs, Kentucky |
| Zip: | 42642-0072 |
| Phone Number: | 270-866-2686 |
Patients can reach Lake Cumberland Pharmacy Llc at
124 Dowell Rd, Russell Springs, Kentucky or can
call on customer care at 270-866-2686.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 December, 2025.