1194277681 NPI number — AIDS PROJECT OF THE OZARKS

Table of content: (NPI 1194277681)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1194277681 NPI number — AIDS PROJECT OF THE OZARKS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
AIDS PROJECT OF THE OZARKS
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
APO PHARMACY
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1194277681
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/28/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
320 S POLK STREET, SUITE 200
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
AMARILLO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
79101-1436
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
806-242-7782
Provider Business Mailing Address Fax Number:
806-324-5495

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1636 S GLENSTONE AVENUE, SUITE 108
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SPRINGFIELD
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
65804-1527
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
833-521-0877
Provider Business Practice Location Address Fax Number:
806-324-5495
Provider Enumeration Date:
10/31/2016

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
WRIGHT
Authorized Official First Name:
JOEL
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT PHARMACY SERVICES
Authorized Official Telephone Number:
806-242-7782

Provider Taxonomy Codes

  • Taxonomy code: 3336C0003X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 3336S0011X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 600045091 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".
  • Identifier: MA8341 . This is a "IMMUNIZATION" identifier . This identifiers is of the category "OTHER".