Basic Information
| Provider Information | |||||||||
| NPI: | 1669461109 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | HEALTH HELP INC | ||||||||
| LastName: | |||||||||
| FirstName: | |||||||||
| MiddleName: | |||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | |||||||||
| OtherOrganizationName: | BEREA WHITE HOUSE CLINIC PHARMACY | ||||||||
| OtherOrganizationType: | 3 | ||||||||
| OtherLastName: | |||||||||
| OtherFirstName: | |||||||||
| OtherMiddleName: | |||||||||
| OtherNamePrefix: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 104 LEGACY DR | ||||||||
| Address2: | |||||||||
| City: | BEREA | ||||||||
| State: | KY | ||||||||
| PostalCode: | 404039594 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8599862323 | ||||||||
| FaxNumber: | 8599851035 | ||||||||
| Practice Location | |||||||||
| Address1: | 104 LEGACY DR | ||||||||
| Address2: | |||||||||
| City: | BEREA | ||||||||
| State: | KY | ||||||||
| PostalCode: | 404039594 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8599862323 | ||||||||
| FaxNumber: | 8599851035 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/18/2005 | ||||||||
| LastUpdateDate: | 08/12/2008 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
| NPIDeactivationDate: | |||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | CHEEK | ||||||||
| AuthorizedOfficialFirstName: | REBECCA | ||||||||
| AuthorizedOfficialMiddleName: | G | ||||||||
| AuthorizedOfficialTitleorPosition: | DIRECTOR OF PHARMACY | ||||||||
| AuthorizedOfficialTelephone: | 8599862323 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
| ParentOrganizationLBN: | |||||||||
| AuthorizedOfficialNamePrefix: | DR. | ||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | PHARMD | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 332B00000X | 90009911 | KY | N | Suppliers | Durable Medical Equipment & Medical Supplies | 333600000X | P06882 | KY | Y | Suppliers | Pharmacy |
ID Information
| ID | Type | State | Issuer | Description | 54005673 | 05 | KY | MEDICAID | P06882 | 01 | KY | STATE LICENSE | OTHER | BB8498962 | 01 | KY | DEA NUMBER | OTHER | 90009911 | 05 | KY | MEDICAID |