Healthcare Provider Details

I. General information

NPI: 1225112352
Provider Name (Legal Business Name): LONDON APOTHECARY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2006
Last Update Date: 04/25/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

54 W HIGH ST STE A
LONDON OH
43140-1075
US

IV. Provider business mailing address

54 W HIGH ST STE A
LONDON OH
43140-1075
US

V. Phone/Fax

Practice location:
  • Phone: 740-852-5131
  • Fax: 740-852-5135
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number020561550
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: ERNEST SPARKS
Title or Position: OWNER
Credential: RPH
Phone: 740-852-5131