Provider Demographics
NPI:1629738760
Name:NEPHRON PHARMACY LLC
Entity Type:Organization
Organization Name:NEPHRON PHARMACY LLC
Other - Org Name:SUPERIOR POSTOP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:HANK
Authorized Official - Middle Name:J
Authorized Official - Last Name:JIBAJA
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:407-579-4797
Mailing Address - Street 1:3499 BLAZER PARKWAY
Mailing Address - Street 2:SUITE G10 NORTH
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40509
Mailing Address - Country:US
Mailing Address - Phone:859-327-3102
Mailing Address - Fax:803-219-3858
Practice Address - Street 1:3499 BLAZER PKWY STE G10 NORTH
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509-1850
Practice Address - Country:US
Practice Address - Phone:859-327-3102
Practice Address - Fax:803-219-3858
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-29
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy