The Vintage Pharmacy

LBN: Apotheke Inc
The Vintage Pharmacy is an health care organization with primary practice located at 1605 State Route 60 Suite 11, Vermilion OH 44089. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Community/Retail Pharmacy, Suppliers / Compounding Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Apotheke Inc can be contacted via phone (440) 967-3100, or through Ickes, Kimberly via phone (440) 963-7760.

Contact Information

Primary practice address
1605 State Route 60 Suite 11 Vermilion OH 44089
Phone: (440) 967-3100
Fax: (440) 967-3110
Website:
Map and Directions
Authorized official contact:
Name: Ickes, Kimberly RPH
Phone: (440) 963-7760

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X
Suppliers / Community/Retail Pharmacy 3336C0003X 021800200 Ohio
Suppliers / Compounding Pharmacy 3336C0004X

Profile Details

NPI number 1669577425
LBN Legal business name Apotheke Inc
DBA Doing business as The Vintage Pharmacy
Authorized official Ickes, Kimberly RPH
Entity Organization
Organization subpart 1 No
Enumeration date Sep 14th, 2006
Last updated Oct 5th, 2011 - about 15 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1669577425 NPPES
Ohio MEDICAID 0624677
Ohio Other 3644956

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