Madison Avenue Pharmacy Inc
LBN: Madison Avenue Pharmacy Inc
Madison Avenue Pharmacy Inc is an health care organization with primary practice located at 640 N Fountain Ave , Springfield OH 45504-2202. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy, Suppliers / Compounding Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty.
Madison Avenue Pharmacy Inc can be contacted via phone (937) 323-1841, or through Juergens, Eric via phone (937) 323-1841.
Contact Information
Primary practice address
640 N Fountain Ave
Springfield OH 45504-2202
Phone: (937) 323-1841
Fax: (937) 323-1016
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Pharmacy | 333600000X | ||
| Suppliers / Community/Retail Pharmacy | 3336C0003X | 022269200 | Ohio |
| Suppliers / Compounding Pharmacy | 3336C0004X |
Profile Details
| NPI number | 1407930530 |
|---|---|
| LBN Legal business name | Madison Avenue Pharmacy Inc |
| DBA Doing business as | Madison Avenue Pharmacy Inc |
| Authorized official | Juergens, Eric RPH |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Oct 25th, 2006 |
| Last updated | Jul 10th, 2013 - about 11 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 | 1407930530 | NPPES |
| Other | 2072490 | PK | |
| MEDICAID | 0081137 | PK |
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