Lake Cumberland Pharmacy LLC
NPI 1912201906 · Community/Retail Pharmacy · Russell Springs, KY
Enrolled with Medicare as Dme Supplier - Pharmacy · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Lake Cumberland Pharmacy LLC is a Community/Retail Pharmacy organization in Russell Springs, KY (NPI 1912201906).
Provider details
- NPI number
- 1912201906
- Entity type
- Organization
- Primary specialty
- Community/Retail PharmacySuppliers
- Organization subpart
- No
- Authorized official
- Jonathan Grider, Managing Member(270) 858-6400
Specialties & taxonomies
Suppliers
Suppliers
- Pharmacy333600000X
Suppliers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
15 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Other names (DBA / former)
- Doing business as
- Lake Cumberland Pharmacy #2
- Doing business as
- Lake Cumberland Pharmacy #2
Registry dates
- Enumerated
- 2011-01-05
- Last updated
- 2022-10-07
- Certified
- 2022-10-07
Frequently asked questions
- What is Lake Cumberland Pharmacy LLC's NPI number?
- Lake Cumberland Pharmacy LLC's National Provider Identifier (NPI) is 1912201906, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Lake Cumberland Pharmacy LLC?
- Lake Cumberland Pharmacy LLC is classified in the NPPES registry as Community/Retail Pharmacy (Suppliers).
- Where is Lake Cumberland Pharmacy LLC located?
- Lake Cumberland Pharmacy LLC's practice location on file with NPPES is 124 Dowell Rd, Russell Springs, KY 42642-4278.
- What is Lake Cumberland Pharmacy LLC's phone number?
- The practice phone number listed in the NPPES registry for Lake Cumberland Pharmacy LLC is (270) 866-2686.
- Does Lake Cumberland Pharmacy LLC accept Medicare?
- Lake Cumberland Pharmacy LLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Lake Cumberland Pharmacy LLC?
- The authorized official listed on Lake Cumberland Pharmacy LLC's NPPES record is Jonathan Grider, Managing Member. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Lake Cumberland Pharmacy LLC's NPI active?
- Yes — Lake Cumberland Pharmacy LLC's NPI (1912201906) is active in the NPPES registry as of the last update on 2022-10-07.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.