Pauls Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

60005616A Issued in IN

Legal business name

PAULS PHARMACY INC

Doing business as

PAULS PHARMACY EAST

Practice address

1150 S Green River Rd
Evansville, IN 47715-6804

Phone

(812) 962-3500

Fax

(812) 962-3510

NPI assigned

Oct 11, 2006

Organization subpart

Yes

Parent organization

PAULS PHARMACY INCAs reported in NPPES

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

Authorized official

Name

Mr. Jacob Paul Mayer, RPHNPI 1083615579

Title

Owner

Phone

(812) 426-5033

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• PAULS PHARMACY EAST Doing business as

Medicare fee-for-service enrollment

Enrolled in IN2 enrollments

Enrollment records 2

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Pauls Pharmacy Inc

  • Community/Retail Pharmacy
  • Evansville, IN
  • NPI 1083615603

  7911945381

  Same PAC ID

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Medicare medical equipment & supply locations

Tax ID family

Pauls Pharmacy Inc3 organizations share this tax ID, including this one

Part of

Pauls Pharmacy Inc

Other organizations with this tax ID 2

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

• Pauls Pharmacy Inc

  • Community/Retail Pharmacy
  • Evansville, IN
  • NPI 1083615603
  NPD tax ID
• Pauls Pharmacy Inc

  • Long Term Care Pharmacy
  • Evansville, IN
  • NPI 1265674097
  NPD tax ID

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jacob Paul Mayer, PHARMD

  • Pharmacist
  • Evansville, IN
  • NPI 1083615579
  NPD (past) Authorized official
• Jeremy Lewis Mann, PHARMD

  • Pharmacist
  • Evansville, IN
  • NPI 1508497611
  NPD
• Scott Michael Schutte, PHARMD

  • Pharmacist
  • Evansville, IN
  • NPI 1265087605
  NPD

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726531200000",
    "number": "1760570030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4111 N SAINT JOSEPH AVE",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477201206",
            "telephone_number": "812-426-5033",
            "fax_number": "812-402-8920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 S GREEN RIVER RD",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477156804",
            "telephone_number": "812-962-3500",
            "fax_number": "812-962-3510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAULS PHARMACY INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PAULS PHARMACY INC",
        "enumeration_date": "2006-10-11",
        "last_updated": "2024-09-17",
        "certification_date": "2024-09-17",
        "status": "A",
        "authorized_official_last_name": "MAYER",
        "authorized_official_first_name": "JACOB",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "812-426-5033",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "IN",
            "license": "60005616A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200337390",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PAULS PHARMACY EAST",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PAULS PHARMACY EAST",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Amal Paul, M.D
• Richard L Paul, MSW LCSW
• Pauls Pharmacy
• Pauls Pharmacy Inc
• Pauls Pharmacy Inc
• August John Paulson, MSW, LCSW
• Breanna Pavlichek
• Caroline R Payne, PHARM D
• Elise Payne, LAT, ATC
• Jeffrey L Payne, M.D.

• Community/Retail Pharmacy in Evansville, IN
• Providers in Evansville, IN by specialty
• Community/Retail Pharmacy in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.