Samuel J Coletta, RPH

Key facts

NPI

1104939263

Entity type

Individual (NPI type 1)

Primary specialty

Pharmacist 183500000X

License

9590 (KY)

Practice address

118 6TH Ave
Dayton, KY 41074-1112

Phone

(859) 491-1700

Fax

(859) 491-7680

NPI assigned

Aug 15, 2006

Sex

Male

Sole proprietor

No

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 and National Provider Directory roles.

• BPRS Inc Community/Retail Pharmacy · Dayton, KY · NPI 1881611499
  NPD (past)

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Credentials

Registered Pharmacist

State licenses

Practice roles

Specialties & licenses

Addresses

Other identifiers

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Mar 30, 2017.

{
    "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
• 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.

All providers in Dayton, KY · Pharmacist in Kentucky