Healthcare Provider Details

I. General information

NPI: 1447143839
Provider Name (Legal Business Name): AMEN BEJOY RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/02/2025
Last Update Date: 06/02/2025
Certification Date: 06/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3229 POPLAR LEVEL RD
LOUISVILLE KY
40213-1030
US

IV. Provider business mailing address

3229 POPLAR LEVEL RD
LOUISVILLE KY
40213-1030
US

V. Phone/Fax

Practice location:
  • Phone: 502-345-1227
  • Fax:
Mailing address:
  • Phone: 502-345-1227
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number025043
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: