Wagners Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

P00851 Issued in KY

Legal business name

WAGNERS PHARMACY INC

Practice address

3113 S 4TH St
Louisville, KY 40214

Phone

(502) 375-3800

Fax

(502) 375-0085

NPI assigned

Jan 30, 2007

Organization subpart

No

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

Authorized official

Name

Ms. Patricia M Wagner

Title

Owner

Phone

(502) 426-1788

Specialties & licenses 2

Addresses

Other identifiers 1

Tax ID family

Wagners Pharmacy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Wagners Pharmacy

  • Pharmacist
  • Louisville, KY
  • NPI 1114016235
  NPD tax ID

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1346025600000",
    "number": "1881731073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3113 S. 4TH ST",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "40214",
            "telephone_number": "502-375-3800",
            "fax_number": "502-375-0085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3113 S 4TH ST",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "40214",
            "telephone_number": "502-375-3800",
            "fax_number": "502-375-0085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAGNERS PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-30",
        "last_updated": "2012-08-27",
        "status": "A",
        "authorized_official_last_name": "WAGNER",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "502-426-1788",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "KY",
            "license": "P00851",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "54004643",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Paula Anne-Marie Wagner, PT
• Shaina Wagner
• Skylar Wagner, LMT
• Stephanie A Wagner, PNP
• Wagners Pharmacy
• Clare Thompson Wahl, PHD
• Lori Lynae Wahl, PT, DPT
• Timothy James Wahl, D.M.D.
• Brett T. Wahlgren, M.D.
• Emily Sarah Wahlgren, BSA, RBT

• Community/Retail Pharmacy in Louisville, KY
• Providers in Louisville, KY by specialty
• Community/Retail Pharmacy in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2012; 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.