NPIMap

Organization Active NPI

Wagners Pharmacy

  • Pharmacist
  • Louisville, KY
National Provider Identifier
1114016235
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
005805 Issued in KY
Legal business name
WAGNERS PHARMACY
Practice address
3113 S 4TH St
Louisville, KY 40214-1710
Phone
(502) 375-3800
Fax
(502) 375-0085
NPI assigned
Oct 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Lee Wagner II, RPH
Title
Owner/President
Phone
(502) 375-3800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PharmacistGroup: 193400000X SINGLE SPECIALTY GROUP 183500000X 005805 KY Primary

Addresses

Primary practice location

3113 S 4TH St
Louisville, KY 40214-1710

Mailing address

3113 S 4TH St
Louisville, KY 40214-1710
Phone (502) 375-3800

National Provider Directory

National Provider Directory
Tax ID family
Wagners Pharmacy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

3113 S 4th St
Louisville, KY 40214
Phone (502) 375-3800

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1114016235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3113 S 4TH ST",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402141710",
            "telephone_number": "502-375-3800",
            "fax_number": "502-375-0085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3113 S 4TH ST",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402141710",
            "telephone_number": "502-375-3800",
            "fax_number": "502-375-0085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAGNERS PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WAGNER",
        "authorized_official_first_name": "LEE",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "502-375-3800",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist",
            "state": "KY",
            "license": "005805",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.