1477893865 NPI number — NAPLES APOTHECARY INC

Table of content: (NPI 1477893865)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1477893865 NPI number — NAPLES APOTHECARY INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NAPLES APOTHECARY INC
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:
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:
1477893865
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/18/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 158
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NAPLES
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
14512-0158
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
585-374-5040
Provider Business Mailing Address Fax Number:
585-374-5042

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
129 S MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NAPLES
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14512-0000
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
585-374-5040
Provider Business Practice Location Address Fax Number:
585-374-5042
Provider Enumeration Date:
02/21/2013

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
RITZLER
Authorized Official First Name:
ANN
Authorized Official Middle Name:
FRANCES
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
585-374-5040

Provider Taxonomy Codes

  • Taxonomy code: 310400000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336L0003X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336C0003X , with the licence number: 031702 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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