Active NPI
Pharm Investco LLC
- Long Term Care Pharmacy
- Miamisburg, OH
National Provider Identifier
1639730369
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Long Term Care Pharmacy
- Legal business name
- PHARM INVESTCO LLC
- Practice address
- 434 Alexandersville Rd
Miamisburg, OH 45342-3658 - Phone
- (937) 435-5751
- NPI assigned
- Jun 24, 2019
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Rutul Shah
- Title
- Manager
- Phone
- (312) 391-6845
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Long Term Care Pharmacy | 3336L0003X | Primary |
Addresses
Primary practice location
434 Alexandersville Rd
Miamisburg, OH 45342-3658
Mailing address
1454 N Milwaukee Ave Apt 4
Chicago, IL 60622-9205
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20241107000998 | OH | Part B Supplier - Pharmacy | 0941630032 | Practice locations: Miamisburg, OH |
National Provider Directory
National Provider DirectoryLocations
434 Alexandersville Rd
Miamisburg, OH 45342
Phone (937) 435-5751
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Pharmacist
- Miamisburg, OH
- NPI 1255906830
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1561334400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1561334400000",
"number": "1639730369",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1454 N MILWAUKEE AVE APT 4",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606229205"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "434 ALEXANDERSVILLE RD",
"city": "MIAMISBURG",
"state": "OH",
"postal_code": "453423658",
"telephone_number": "937-435-5751"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PHARM INVESTCO LLC",
"organizational_subpart": "NO",
"enumeration_date": "2019-06-24",
"last_updated": "2019-06-24",
"status": "A",
"authorized_official_last_name": "SHAH",
"authorized_official_first_name": "RUTUL",
"authorized_official_title_or_position": "MANAGER",
"authorized_official_telephone_number": "312-391-6845",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "3336L0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Long Term Care Pharmacy",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Miamisburg, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.