NPIMap

Organization Active NPI

Pauls Pharmacy Inc

  • Long Term Care Pharmacy
  • Evansville, IN
National Provider Identifier
1265674097
Registry record updated Aug 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
License
60006285A Issued in IN
Legal business name
PAULS PHARMACY INC
Doing business as
PAULS LTC PHARMACY
Practice address
4111 N Saint Joseph Ave
Evansville, IN 47720-1206
Phone
(812) 426-5033
Fax
(812) 402-8920
NPI assigned
Mar 25, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2015

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

Authorized official

Name
Jacob MayerNPI 1083615579
Title
President
Phone
(812) 426-5033

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Long Term Care Pharmacy 3336L0003X 60006285A IN Primary

Addresses

Primary practice location

4111 N Saint Joseph Ave
Evansville, IN 47720-1206

Mailing address

4111 N St Joseph Ave
Evansville, IN 47720
Phone (812) 426-5033

Other identifiers 1

IdentifierTypeStateIssuer
2135286OtherPK

Other names 1

  • PAULS LTC PHARMACY Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Pauls Pharmacy Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

4111 N Saint Joseph Ave
Evansville, IN 47720
Phone (812) 426-5033

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1237939200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1440028800000",
    "number": "1265674097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4111 N ST JOSEPH AVE",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "47720",
            "telephone_number": "812-426-5033",
            "fax_number": "812-402-8920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4111 N SAINT JOSEPH AVE",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477201206",
            "telephone_number": "812-426-5033",
            "fax_number": "812-402-8920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAULS PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-25",
        "last_updated": "2015-08-20",
        "status": "A",
        "authorized_official_last_name": "MAYER",
        "authorized_official_first_name": "JACOB",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "812-426-5033"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "IN",
            "license": "60006285A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2135286",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PAULS LTC PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Evansville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2015; 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.