Andrew Michael Board, PHARMD

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

019287 Issued in KY

Practice address

1100 Hansel Ave
Florence, KY 41042-4869

Phone

(859) 371-2245

NPI assigned

Nov 19, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

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

{
    "created_epoch": "1605744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605744000000",
    "number": "1093318339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 HANSEL AVE",
            "city": "FLORENCE",
            "state": "KY",
            "postal_code": "410424869",
            "telephone_number": "859-371-2245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 HANSEL AVE",
            "city": "FLORENCE",
            "state": "KY",
            "postal_code": "410424869",
            "telephone_number": "859-371-2245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOARD",
        "first_name": "ANDREW",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-11-19",
        "last_updated": "2020-11-19",
        "certification_date": "2020-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "KY",
            "license": "019287",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KY BOARD OF PHARMACY",
            "identifier": "019287",
            "state": "KY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "www.cvs.com",
            "affiliation": "N",
            "endpointDescription": "Cvs",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FLORENCE",
            "address_1": "1100 Hansel Ave",
            "city": "Florence",
            "state": "KY",
            "country_code": "US",
            "postal_code": "410424869",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Community/Retail Pharmacy in Florence, KY
• Providers in Florence, KY by specialty
• Community/Retail Pharmacy in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2020; 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.