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AMC OHIO LLC NPI 1639507106


NPI Information

NPI: 1639507106
Provider Name: AMC OHIO LLC

Doing Business As: EQUITAS HEALTH PHARMACY #2

Classification: Pharmacy - 3336C0003X
Entity Type: Organization

Specialization: Community/Retail Pharmacy

CLIA Number: 36D2157917

Address:
1222 S PATTERSON BLVD
SUITE 110
DAYTON, OH
ZIP 45402
Phone: (937) 424-1440
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AMC OHIO LLC is a community/retail pharmacy pharmacy in Dayton, OH. The provider is a pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. AMC OHIO LLC NPI is 1639507106. The provider is registered as an organization entity type.
The provider Is Doing Business As Equitas Health Pharmacy #2.

The provider's business location address is:

1222 S PATTERSON BLVD
SUITE 110
DAYTON, OH
ZIP 45402-684
Phone: (937) 424-1440
Fax: (937) 608-9450

The provider's authorized official is Peggy Anderson .
The authorized official title is Chief Operating Officer and has the following contact phone number (614) 340-6691.

The CLIA number assigned to this NPI record is 36D2157917 - pharmacy with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/21/2013 and was last updated on 3/7/2017.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1333600000XPharmacyNo
23336C0003XPharmacyCommunity/Retail Pharmacy02260875003OHIOYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
16722950002MEDICARE NSC
22142657OTHERPK
30093981MEDICAIDOHIO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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