Provider Demographics
NPI:1639578024
Name:PAULS PHARMACY
Entity Type:Organization
Organization Name:PAULS PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST IN CHARGE
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:HODGES
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:812-962-3500
Mailing Address - Street 1:1225 WASHINGTON SQ
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47715-6807
Mailing Address - Country:US
Mailing Address - Phone:812-962-3500
Mailing Address - Fax:812-962-3510
Practice Address - Street 1:1225 WASHINGTON SQ
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47715-6807
Practice Address - Country:US
Practice Address - Phone:812-962-3500
Practice Address - Fax:812-962-3510
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-21
Last Update Date:2014-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy