Organization Active NPI

Levi Pharmacy Inc

  • Pharmacist
  • Colorado Springs, CO
National Provider Identifier
1619059656
Registry record updated Jul 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
9538 Issued in CO
Legal business name
LEVI PHARMACY INC
Doing business as
KOHLERS APOTHECARY
Practice address
4020 Palmer Park Blvd
102C
Colorado Springs, CO 80909-3402
Phone
(719) 597-7998
Fax
(719) 597-6951
NPI assigned
Oct 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2015

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

Authorized official

Name
Mr. Jerry David Levi, R.PH.
Title
President Pharmacy Manager
Phone
(719) 597-7998

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PharmacistGroup: 193400000X SINGLE SPECIALTY GROUP 183500000X 9538 CO Primary

Addresses

Primary practice location

4020 Palmer Park Blvd
102C
Colorado Springs, CO 80909-3402

Mailing address

4020 Palmer Park Blvd
102C
Colorado Springs, CO 80909-3402
Phone (719) 597-7998

Other identifiers 2

IdentifierTypeStateIssuer
03491255MedicaidCO
0602296OtherNCPDP PROVIDER ID

Other names 1

  • KOHLERS APOTHECARY Doing business as

National Provider Directory

National Provider Directory

Locations

4020 Palmer Park Blvd
Ste 102C
Colorado Springs, CO 80909
Phone (719) 597-7998

NPI Registry JSON

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437609600000",
    "number": "1619059656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4020 PALMER PARK BLVD",
            "address_2": "102C",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809093402",
            "telephone_number": "719-597-7998",
            "fax_number": "719-597-6951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4020 PALMER PARK BLVD",
            "address_2": "102C",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809093402",
            "telephone_number": "719-597-7998",
            "fax_number": "719-597-6951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEVI PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-19",
        "last_updated": "2015-07-23",
        "status": "A",
        "authorized_official_last_name": "LEVI",
        "authorized_official_first_name": "JERRY",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "PRESIDENT     PHARMACY MANAGER",
        "authorized_official_telephone_number": "719-597-7998",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "R.PH."
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist",
            "state": "CO",
            "license": "9538",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03491255",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER ID",
            "identifier": "0602296",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "KOHLERS APOTHECARY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 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.