Provider Demographics
NPI:1164899696
Name:EMPLOYER'S COLLECTIVE
Entity Type:Organization
Organization Name:EMPLOYER'S COLLECTIVE
Other - Org Name:POKITDOK, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CORPORATE DEVELOPMENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:J
Authorized Official - Last Name:BARAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-212-9903
Mailing Address - Street 1:100 CALHOUN STREET, SUITE 210
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29492
Mailing Address - Country:US
Mailing Address - Phone:843-212-2085
Mailing Address - Fax:
Practice Address - Street 1:100 CALHOUN STREET, SUITE 210
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29492
Practice Address - Country:US
Practice Address - Phone:843-212-2085
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-01
Last Update Date:2018-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336S0011X
CO12500000033336M0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336M0002XSuppliersPharmacyMail Order Pharmacy
No333600000XSuppliersPharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2153767OtherPK