NPIMap

Organization Active NPI

Park Ave Apothecary LLC

  • Long Term Care Pharmacy
  • Colorado Springs, CO
National Provider Identifier
1043862485
Registry record updated Jul 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
Legal business name
PARK AVE APOTHECARY LLC
Practice address
2431 N Union Blvd
Colorado Springs, CO 80909-1107
Phone
(719) 630-3154
Fax
(719) 630-1640
NPI assigned
Jul 16, 2019
Organization subpart
Yes
Parent organization
PARK AVE APOTHECARYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 16, 2019

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

Authorized official

Name
Patrick Scheels
Title
Owner
Phone
(303) 898-7183

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Long Term Care Pharmacy 3336L0003X Primary

Addresses

Primary practice location

2431 N Union Blvd
Colorado Springs, CO 80909-1107

Mailing address

2431 N Union Blvd
Colorado Springs, CO 80909-1107
Phone (719) 630-3154

Other identifiers 3

IdentifierTypeStateIssuer
03577319MedicaidCO
7599910001OtherPTAN
240000040OtherCOSTATE PHARMACY LICENSE

Other names 1

  • Medicine Shoppe #437 Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Park Ave Apothecary LLC2 organizations share this tax ID, including this one
Part of
Park Ave Apothecary LLC

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2431 N Union Blvd
Colorado Springs, CO 80909
Phone (719) 630-3154

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1563235200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1563235200000",
    "number": "1043862485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2431 N UNION BLVD",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809091107",
            "telephone_number": "719-630-3154",
            "fax_number": "719-630-1640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2431 N UNION BLVD",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809091107",
            "telephone_number": "719-630-3154",
            "fax_number": "719-630-1640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK AVE APOTHECARY LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PARK AVE APOTHECARY",
        "enumeration_date": "2019-07-16",
        "last_updated": "2019-07-16",
        "status": "A",
        "authorized_official_last_name": "SCHEELS",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "303-898-7183"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03577319",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "7599910001",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE PHARMACY LICENSE",
            "identifier": "240000040",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medicine Shoppe #437",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2019; 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.