1770809253 NPI number — ANDERIS APOTHECARY LLC

Table of content: DR. JAY ISAAC STEVEN SEMEL DPT (NPI 1215459342)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1770809253 NPI number — ANDERIS APOTHECARY LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ANDERIS APOTHECARY 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:
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:
1770809253
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/14/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
601 SW CORPORATE VW
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TOPEKA
Provider Business Mailing Address State Name:
KS
Provider Business Mailing Address Postal Code:
66615-1244
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
785-271-8000
Provider Business Mailing Address Fax Number:
785-271-8001

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
601 SW CORPORATE VW
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TOPEKA
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66615-1244
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
785-271-8000
Provider Business Practice Location Address Fax Number:
785-271-8001
Provider Enumeration Date:
04/09/2010

Additional Information

Authorized Official

Authorized Official Last Name:
HARRIS
Authorized Official First Name:
LESLEY
Authorized Official Middle Name:
Authorized Official Title or Position:
LLC MEMBER/PHARMACIST
Authorized Official Telephone Number:
785-364-2114

Provider Taxonomy Codes

  • Taxonomy code: 333600000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336C0003X , with the licence number: 210311 , registered in the state of KS ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 2126603 . This is a "PK" identifier . This identifiers is of the category "OTHER".
  • Identifier: 200673101A , issued by the state of ( KS ) . This identifiers is of the category "MEDICAID".




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