1265432181 NPI number — ROBERT YOWLER

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1265432181 NPI number — ROBERT YOWLER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ROBERT YOWLER
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:
Provider Other Organization Name Type Code:
6
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:
1265432181
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/07/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 243
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BEDFORD
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
40006-0243
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
502-255-3540
Provider Business Mailing Address Fax Number:
502-255-3615

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
325 HIGHWAY 42 E
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BEDFORD
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40006-7624
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
502-255-3540
Provider Business Practice Location Address Fax Number:
502-255-3615
Provider Enumeration Date:
07/21/2005

Additional Information

Authorized Official

Authorized Official Last Name:
YOWLER
Authorized Official First Name:
ROBERT
Authorized Official Middle Name:
PARKER
Authorized Official Title or Position:
REGISTERED PHARMACIST OWNER OF MORG
Authorized Official Telephone Number:
502-255-3540

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X , with the licence number:  PO1566 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 3336C0003X , with the licence number: PO1566 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 54019153 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: FLU 0266 . This is a "FLU" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 1816048 . This is a "NABP" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 9001112300 . This is a "MEDICAID DME SUPPLIER NO." identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: PO1566 . This is a "PHARMACY" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".




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