Healthcare Provider Details
I. General information
NPI: 1851976906
Provider Name (Legal Business Name): OP PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/10/2021
Last Update Date: 01/16/2024
Certification Date: 01/16/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
34 SCHROEDER CT STE 310
MADISON WI
53711-2528
US
IV. Provider business mailing address
805 N WHITTINGTON PKWY STE 400
LOUISVILLE KY
40222-7101
US
V. Phone/Fax
- Phone: 608-733-6384
- Fax: 608-710-4855
- Phone: 502-627-7100
- Fax: 855-217-7498
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336C0004X |
| Taxonomy | Compounding Pharmacy |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JENNIFER
YOWLER
Title or Position: MANAGING MEMBER
Credential:
Phone: 502-394-6100