Joshua Spachman
Individual provider Active NPI Pharmacist · Elizabethtown, KY
NPI 1124633862 · NPPES record last updated Sep 10, 2020
Key facts
- NPI
- 1124633862
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 016205 (KY)
- Practice address
- 1602 N Dixie Ave
Elizabethtown, KY 42701-2682 - Phone
- (270) 737-3713
- Fax
- (270) 737-7878
- NPI assigned
- Sep 10, 2020
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 016205 | KY | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Current |
Accepting new patients | |
| Walgreen Co | Past |
Accepting new patients |
Locations
1602 N Dixie Ave
Elizabethtown, KY 42701
Phone (270) 737-3713
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 016205 | KY | Yes |
Addresses
Primary practice location
1602 N Dixie Ave
Elizabethtown, KY 42701-2682
Mailing address
1602 N Dixie Ave
Elizabethtown, KY 42701-2682
Phone (270) 737-3713
NPI Registry JSON
{
"created_epoch": "1599696000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1599696000000",
"number": "1124633862",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1602 N DIXIE AVE",
"city": "ELIZABETHTOWN",
"state": "KY",
"postal_code": "427012682",
"telephone_number": "270-737-3713"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1602 N DIXIE AVE",
"city": "ELIZABETHTOWN",
"state": "KY",
"postal_code": "427012682",
"telephone_number": "270-737-3713",
"fax_number": "270-737-7878"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPACHMAN",
"first_name": "JOSHUA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-09-10",
"last_updated": "2020-09-10",
"certification_date": "2020-09-09",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "KY",
"license": "016205",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Elizabethtown, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 10, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.