Provider Demographics
NPI:1225112352
Name:LONDON APOTHECARY INC
Entity Type:Organization
Organization Name:LONDON APOTHECARY INC
Other - Org Name:MEDICINE SHOPPE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERNEST
Authorized Official - Middle Name:
Authorized Official - Last Name:SPARKS
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:740-852-5131
Mailing Address - Street 1:54 W HIGH ST
Mailing Address - Street 2:STE A
Mailing Address - City:LONDON
Mailing Address - State:OH
Mailing Address - Zip Code:43140-1075
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:54 W HIGH ST
Practice Address - Street 2:STE A
Practice Address - City:LONDON
Practice Address - State:OH
Practice Address - Zip Code:43140-1075
Practice Address - Country:US
Practice Address - Phone:740-852-5131
Practice Address - Fax:740-852-5135
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-25
Last Update Date:2014-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0205615503336C0003X
3336C0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
3650531OtherOTHER ID NUMBER
OH0716612Medicaid
1063100001Medicare NSC