Provider Type Icon

PUCKETT ULLOM INC NPI 1437246626


NPI Information

NPI: 1437246626
Provider Name: PUCKETT ULLOM INC

Doing Business As: ROUBENS PHARMACY

Classification: Pharmacy - 333600000X
Entity Type: Organization
Address:
3501 POPLAR LEVEL RD
LOUISVILLE, KY
ZIP 40213
Phone: (502) 458-3229
Get Directions

PUCKETT ULLOM INC is a pharmacy in Louisville, KY. The provider is a facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. PUCKETT ULLOM INC NPI is 1437246626. The provider is registered as an organization entity type.
The provider Is Doing Business As Roubens Pharmacy.

The provider's business location address is:

3501 POPLAR LEVEL RD
LOUISVILLE, KY
ZIP 40213-009
Phone: (502) 458-3229
Fax: (502) 452-6371

The provider's authorized official is Brian Ullom .
The authorized official title is Owner and has the following contact phone number (502) 458-3229.

The enumeration date for this NPI number is 10/7/2006 and was last updated on 8/22/2020.


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
1333600000XPharmacyPO6088KENTUCKYYes
23336C0003XPharmacyCommunity/Retail PharmacyX

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
154030069MEDICAIDKENTUCKY
21802241OTHEROTHER ID NUMBER-COMMERCIAL NUMBER

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.