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General NPI Number Information
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NPI Number | 1669577425
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Entity Type | Organization
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Legal Business Name | APOTHEKE INC
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Dates
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Enumeration Date | 09/14/2006
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Last Update Date | 10/05/2011
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Provider Practice Location Address
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Address Line | 1605 STATE ROUTE 60 SUITE 11
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City | VERMILION
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State | OH
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Zip | 44089
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Country | US
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Telephone | 440-967-3100
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Fax | 440-967-3110
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Provider Business Mailing Address
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Address Line | 1605 STATE ROUTE 60 SUITE 11
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City | VERMILION
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State | OH
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Zip | 44089
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Country | US
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Telephone | 440-967-3100
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Fax | 440-967-3110
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Authorized Official
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Title or Position | OWNER
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Name | KIMBERLY ICKES
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Credential | RPH
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Telephone | 440-963-7760
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 021800200
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License Number State | OH
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