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NPI Code Detail

MEDICARE: JOHN SONDEJ

MEDICARE: JOHN SONDEJ
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist019235KY

General Provider Information

NPI Number : 1962013672
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN SONDEJ
Provider Business Mailing Address
First Line : 1475 DIXIE HWY
Second Line :
City : LOUISVILLE
State : KY
Zip : 40210-1767
Country : US
Telephone Number : 502-776-1840
Fax Number :
Provider Business Practice Location Address
First Line : 1475 DIXIE HWY
Second Line :
City : LOUISVILLE
State : KY
Zip : 40210-1767
Country : US
Telephone Number : 502-776-1840
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/14/2020
Last Update Date : 08/14/2020

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