Provider Demographics
NPI:1164437711
Name:ADIO PHARMACY DISTRIBUTION SERVICES PLLC
Entity Type:Organization
Organization Name:ADIO PHARMACY DISTRIBUTION SERVICES PLLC
Other - Org Name:ADIO PHARMACY DISTRIBUTION SERVICES
Other - Org Type:Other Name
Authorized Official - Title/Position:PIC
Authorized Official - Prefix:
Authorized Official - First Name:ARIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:HOPPENRATH
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:270-234-8111
Mailing Address - Street 1:150 RALEIGH DR
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:42701-7139
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:150 RALEIGH DR
Practice Address - Street 2:
Practice Address - City:ELIZABETHTOWN
Practice Address - State:KY
Practice Address - Zip Code:42701-7139
Practice Address - Country:US
Practice Address - Phone:270-234-8111
Practice Address - Fax:270-234-8195
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-30
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No333600000XSuppliersPharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY5401119200Medicaid
2034590OtherPK