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General NPI Number Information
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NPI Number | 1760570030
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Entity Type | Organization
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Legal Business Name | PAULS PHARMACY INC
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Dates
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Enumeration Date | 10/11/2006
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Last Update Date | 09/17/2024
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Provider Practice Location Address
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Address Line | 1150 S GREEN RIVER RD
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City | EVANSVILLE
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State | IN
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Zip | 47715-6804
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Country | US
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Telephone | 812-962-3500
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Fax | 812-962-3510
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Provider Business Mailing Address
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Address Line | 4111 N SAINT JOSEPH AVE
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City | EVANSVILLE
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State | IN
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Zip | 47720-1206
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Country | US
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Telephone | 812-426-5033
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Fax | 812-402-8920
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Authorized Official
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Title or Position | OWNER
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Name | MR. JACOB PAUL MAYER
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Credential | RPH
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Telephone | 812-426-5033
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 60005616A
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License Number State | IN
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