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1174664619 NPI number — NEW ERA OF KENTUCKY, INC

NPI Number: 1174664619
Health Care Provider/Practitioner: NEW ERA OF KENTUCKY, INC

Information about “1174664619” NPI (NEW ERA OF KENTUCKY, INC) exists in 1174664619 in HTML format HTML  |  1174664619 in plain Text format TXT  |  1174664619 in PDF (Portable Document Format) PDF  |  1174664619 in an XML format XML  formats.

NPI Number : 1174664619 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1174664619",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "NEW ERA OF KENTUCKY, INC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": "6",
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "100 S MAIN ST",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "VERSAILLES",
    "MailingAddressStateName": "KY",
    "MailingAddressPostalCode": "40383-1214",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "859-873-3007",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "100 S MAIN ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "VERSAILLES",
    "PracticeLocationAddressStateName": "KY",
    "PracticeLocationAddressPostalCode": "40383-1214",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "859-873-3007",
    "PracticeLocationAddressFaxNumber": "859-879-1785",
    "EnumerationDate": "02/09/2007",
    "LastUpdateDate": "06/13/2022",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "SPENCER",
    "AuthorizedOfficialFirstName": "KELLEY",
    "AuthorizedOfficialMiddleName": "SUE",
    "AuthorizedOfficialTitle": "PHARMACIST",
    "AuthorizedOfficialNamePrefix": "MS.",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "RPH",
    "AuthorizedOfficialTelephoneNumber": "859-873-3007",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "3336C0003X",
        "TaxonomyName": "Community/Retail Pharmacy",
        "LicenseNumber": "P06576",
        "LicenseNumberStateCode": "KY",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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