Organization Active NPI

Pharm Investco LLC

  • Long Term Care Pharmacy
  • Miamisburg, OH
National Provider Identifier
1639730369
Registry record updated Jun 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
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

Updated by the provider on Jun 24, 2019

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)CodeLicenseStatePrimary
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 IDStateProvider typePAC IDDetails
O20241107000998 OH Part B Supplier - Pharmacy 0941630032 Practice locations: Miamisburg, OH

National Provider Directory

National Provider Directory

Locations

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.

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.

Verify at the official NPI Registry.