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NPI Code Detail

MEDICARE: KAUP PHARMACY INC

MEDICARE: KAUP PHARMACY INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1332BP3500XParenteral & Enteral Nutrition Supplies (DME)020170400OH
2333600000XPharmacy
33336C0003XCommunity/Retail Pharmacy
43336C0004XCompounding Pharmacy
53336L0003XLong Term Care Pharmacy64000258AIN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12175835OTHERPK
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1609378611
Entity Type Code : Organization
Provider Name (Legal Business Name) : KAUP PHARMACY INC
Provider Business Mailing Address
First Line : PO BOX 605
Second Line :
City : FORT RECOVERY
State : OH
Zip : 45846-0605
Country : US
Telephone Number : 419-375-2323
Fax Number : 419-375-4488
Provider Business Practice Location Address
First Line : 102 N WAYNE ST
Second Line :
City : FORT RECOVERY
State : OH
Zip : 45846-8059
Country : US
Telephone Number : 419-375-2323
Fax Number : 419-375-4488
Authorized Official
Title or Position : PRESIDENT
Name : JASON ANDREWS
Credential :
Telephone Number : 419-375-2323
Provider Enumeration Date : 03/06/2018
Last Update Date : 09/04/2024

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1518801810 — ELI ANTHONY SCHMITMEYER
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Directions to “KAUP PHARMACY INC ” Practice Location

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