1497097745 NPI number — AP PHARMACY LLC

Table of content: (NPI 1497097745)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1497097745 NPI number — AP PHARMACY LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
AP PHARMACY LLC
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:
1497097745
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/16/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1502 OXFORD DR STE 150
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GEORGETOWN
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
40324-8095
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
502-863-3784
Provider Business Mailing Address Fax Number:
502-863-3789

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1502 OXFORD DR
Provider Second Line Business Practice Location Address:
SUIT - 150
Provider Business Practice Location Address City Name:
GEORGETOWN
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40324-8094
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
502-863-3784
Provider Business Practice Location Address Fax Number:
502-863-3789
Provider Enumeration Date:
03/25/2013

Additional Information

Authorized Official

Authorized Official Last Name:
PATEL
Authorized Official First Name:
BIJALKUMAR
Authorized Official Middle Name:
JAYANTILAL
Authorized Official Title or Position:
PHARMACIST/OWNER
Authorized Official Telephone Number:
859-940-2950

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 333600000X , with the licence number: P07570 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1833614 . This is a "NCPDP PROVIDER IDENTIFICATION NUMBER" identifier . This identifiers is of the category "OTHER".
  • Identifier: 7100244060 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".




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