The Vintage Pharmacy
LBN: Apotheke Inc
The Vintage Pharmacy is an health care organization with primary practice located at 1605 State Route 60 Suite 11, Vermilion OH 44089. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Community/Retail Pharmacy, Suppliers / Compounding Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty.
Apotheke Inc can be contacted via phone (440) 967-3100, or through Ickes, Kimberly via phone (440) 963-7760.
Contact Information
Primary practice address
1605 State Route 60 Suite 11
Vermilion OH 44089
Phone: (440) 967-3100
Fax: (440) 967-3110
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Durable Medical Equipment & Medical Supplies | 332B00000X | ||
| Suppliers / Community/Retail Pharmacy | 3336C0003X | 021800200 | Ohio |
| Suppliers / Compounding Pharmacy | 3336C0004X |
Profile Details
| NPI number | 1669577425 |
|---|---|
| LBN Legal business name | Apotheke Inc |
| DBA Doing business as | The Vintage Pharmacy |
| Authorized official | Ickes, Kimberly RPH |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Sep 14th, 2006 |
| Last updated | Oct 5th, 2011 - about 13 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1669577425 | NPPES |
| Ohio | MEDICAID | 0624677 | |
| Ohio | Other | 3644956 |
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