Audubon Pharmacy Inc
Organization Active NPI Community/Retail Pharmacy · Louisville, KY
NPI 1306943147 · NPPES record last updated Dec 29, 2015
Key facts
- NPI
- 1306943147
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- P07058 (KY)
- Legal business name
- AUDUBON PHARMACY INC
- Practice address
- 3503 Poplar Level Rd
Louisville, KY 40213-1009 - Phone
- (502) 371-1002
- Fax
- (502) 371-1005
- NPI assigned
- Sep 20, 2006
- Organization subpart
- No
Authorized official
- Name
- Traci Ullom, RPH
- Title
- Owner
- Phone
- (502) 371-1002
National Provider Directory
Locations
3503 Poplar Level Rd
Louisville, KY 40213
Phone (502) 371-1002
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | P07058 | KY | Yes |
Addresses
Primary practice location
3503 Poplar Level Rd
Louisville, KY 40213-1009
Mailing address
3503 Poplar Level Rd
Louisville, KY 40213-1009
Phone (502) 371-1002
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2034337 | Other | PK | |
| 54011911 | Medicaid | KY |
Other names
- AUDUBON PHARMACY
Other providers in Louisville, KY
- Attuned Nutrition LLC
- Laura Ann Atwood
- Phyllis Atzinger
- Steve M Auden
- Audrey Glaize, LLC
- Jonathan Keith Auerbach
- Priscilla Jane Auerweck
- William E. Aufox
- Abigail Claire Augenstein
- Isabell Augenstein
All providers in Louisville, KY · Community/Retail Pharmacy in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 29, 2015. 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.