Active NPI
Samuel J Coletta, RPH
- Pharmacist
- Dayton, KY
National Provider Identifier
1104939263
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 9590
- Practice address
- 118 6TH Ave
Dayton, KY 41074-1112 - Phone
- (859) 491-1700
- Fax
- (859) 491-7680
- NPI assigned
- Aug 15, 2006
- Last updated
- Mar 30, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 9590 | KY | Primary |
Addresses
Primary practice location
118 6TH Ave
Dayton, KY 41074-1112
Mailing address
640 Western Ave
Covington, KY 41011-1042
Phone (859) 750-4975
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9590 | Other | KY | KENTUCKY PHARMACIST LICEN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Pharmacist
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| BPRS Inc | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155600000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1490832000000",
"number": "1104939263",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "640 WESTERN AVE",
"city": "COVINGTON",
"state": "KY",
"postal_code": "410111042",
"telephone_number": "859-750-4975"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "118 6TH AVE",
"city": "DAYTON",
"state": "KY",
"postal_code": "410741112",
"telephone_number": "859-491-1700",
"fax_number": "859-491-7680"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLETTA",
"first_name": "SAMUEL",
"middle_name": "J",
"name_prefix": "Mr.",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-15",
"last_updated": "2017-03-30",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "KY",
"license": "9590",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "KENTUCKY PHARMACIST LICEN",
"identifier": "9590",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Dayton, KY
- Dusty Lee Ashford, LMT
- Cheryl Yvonne Elizabeth Bailey Salary, MD
- BPRS Inc (Avenue Pharmacy)
- Susan Diane Brackney, RN, MSN, PMHNP-BC
- Grace Elizabeth Burchfield
- Barbara Sue Cook, D.C.
- Dayton Independent Schools
- Dayton Independent Schools
- Fire Department of Bellevue Dayton
- Healthpoint Family Care, Inc.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.