Pet360 Pharmacy LLC

Primary specialty

PharmacyTaxonomy code 333600000X

License

P07685 Issued in KY

Legal business name

PET360 PHARMACY LLC

Doing business as

Pet360 Pharmacy LLC

Practice address

2815 Watterson TRL
Louisville, KY 40299-3868

Phone

(502) 716-7301

Fax

(866) 253-0274

NPI assigned

Mar 9, 2017

Organization subpart

No

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

Authorized official

Name

Justin Mills

Title

Pic

Phone

(502) 716-7301

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Pet360 Pharmacy LLC Doing business as

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

{
    "created_epoch": "1489017600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1489017600000",
    "number": "1518408665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2815 WATTERSON TRL",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402993868",
            "telephone_number": "502-716-7301",
            "fax_number": "866-253-0274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2815 WATTERSON TRL",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402993868",
            "telephone_number": "502-716-7301",
            "fax_number": "866-253-0274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PET360 PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-09",
        "last_updated": "2017-03-09",
        "status": "A",
        "authorized_official_last_name": "MILLS",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_title_or_position": "PIC",
        "authorized_official_telephone_number": "502-716-7301"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "KY",
            "license": "P07685",
            "primary": true
        },
        {
            "code": "3336M0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Mail Order Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2168106",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pet360 Pharmacy LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Personal Options Homecare, LLC
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• Melina Jo Persson
• Pet CT Management LLC
• Pet360 (Petscriptions)
• Lavanya Wijeratne Peter, PHARM.D.
• Todd Charles Peter, D.M.D.
• Alexandra Dawn Peters, M.ED., LPCC-S
• Christopher K Peters, MD
• Colin Peters

• Pharmacy in Louisville, KY
• Providers in Louisville, KY by specialty
• Pharmacy in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2017; 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.