Active NPI
Solange Mukom
- Pharmacist
- Louisville, KY
National Provider Identifier
1205592631
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 022417
- Practice address
- 3997 7TH Street Rd
Louisville, KY 40216-4103 - Phone
- (502) 448-3383
- NPI assigned
- Nov 10, 2021
- Sex
- Female
- 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 | 022417 | KY | Primary |
Addresses
Primary practice location
3997 7TH Street Rd
Louisville, KY 40216-4103
Mailing address
3997 7TH Street Rd
Louisville, KY 40216-4103
Phone (502) 448-3383
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 022417 | KY | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kentucky CVS Pharmacy, L.L.C. | 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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1636502400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1636502400000",
"number": "1205592631",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3997 7TH STREET RD",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402164103",
"telephone_number": "502-448-3383"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3997 7TH STREET RD",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402164103",
"telephone_number": "502-448-3383"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MUKOM",
"first_name": "SOLANGE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-11-10",
"last_updated": "2021-11-10",
"certification_date": "2021-11-10",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "KY",
"license": "022417",
"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 Nov 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.