NPIMap

Organization Active NPI

Good Samaritan Outpatient Pharmacy

  • Community/Retail Pharmacy
  • Cincinnati, OH
National Provider Identifier
1497842991
Registry record updated Oct 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
020030650 Issued in OH
Legal business name
GOOD SAMARITAN OUTPATIENT PHARMACY
Practice address
375 Dixmyth Ave
Cincinnati, OH 45220
Phone
(513) 872-1559
Fax
(513) 475-5878
NPI assigned
Oct 6, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2010

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

Authorized official

Name
Mr. Leonard Kaes, RPH
Title
Pharmacy Manager
Phone
(513) 872-3550

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 020030650 OH Primary

Addresses

Primary practice location

375 Dixmyth Ave
Cincinnati, OH 45220

Mailing address

375 Dixmyth Ave
Cincinnati, OH 45220
Phone (513) 872-1559

Other identifiers 3

IdentifierTypeStateIssuer
020030650OtherOHTERMINAL DISTRIBUTER
2312867MedicaidOH
3661851OtherOHNCPDP

National Provider Directory

National Provider Directory
Tax ID family
Good Samaitan Hospital9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

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

NPI Registry JSON

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1286496000000",
    "number": "1497842991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "375 DIXMYTH AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "45220",
            "telephone_number": "513-872-1559",
            "fax_number": "513-475-5878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375 DIXMYTH AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "45220",
            "telephone_number": "513-872-1559",
            "fax_number": "513-475-5878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOOD SAMARITAN OUTPATIENT PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-06",
        "last_updated": "2010-10-08",
        "status": "A",
        "authorized_official_last_name": "KAES",
        "authorized_official_first_name": "LEONARD",
        "authorized_official_title_or_position": "PHARMACY MANAGER",
        "authorized_official_telephone_number": "513-872-3550",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OH",
            "license": "020030650",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TERMINAL DISTRIBUTER",
            "identifier": "020030650",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2312867",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "3661851",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2010; 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.