Pagosa Health

Primary specialty

Mail Order PharmacyTaxonomy code 3336M0002X

License

60006342A Issued in IN

Legal business name

PAGOSA HEALTH

Doing business as

Pagosa Health

Practice address

62 Doughty Rd Ste 4
Lawrenceburg, IN 47025-2951

Phone

(888) 821-9982

Fax

(800) 218-8256

NPI assigned

Jul 24, 2013

Last updated

Jul 24, 2013By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ronald Koehler

Title

Director of Pharmacy Operation

Phone

(859) 638-2795

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Pagosa Health Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1374624000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1374624000000",
    "number": "1043652654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "62 DOUGHTY RD STE 4",
            "city": "LAWRENCEBURG",
            "state": "IN",
            "postal_code": "470252951",
            "telephone_number": "888-821-9982",
            "fax_number": "800-218-8256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "62 DOUGHTY RD STE 4",
            "city": "LAWRENCEBURG",
            "state": "IN",
            "postal_code": "470252951",
            "telephone_number": "888-821-9982",
            "fax_number": "800-218-8256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAGOSA HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-24",
        "last_updated": "2013-07-24",
        "status": "A",
        "authorized_official_last_name": "KOEHLER",
        "authorized_official_first_name": "RONALD",
        "authorized_official_title_or_position": "DIRECTOR OF PHARMACY OPERATION",
        "authorized_official_telephone_number": "859-638-2795"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336M0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Mail Order Pharmacy",
            "state": "IN",
            "license": "60006342A",
            "primary": true
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2141276",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pagosa Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Mail Order Pharmacy in Lawrenceburg, IN
• Providers in Lawrenceburg, IN by specialty
• Mail Order Pharmacy in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.