Provider Demographics
NPI:1427884295
Name:MEDICINLOGIC LLC
Entity type:Organization
Organization Name:MEDICINLOGIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:JORDAN
Authorized Official - Middle Name:MICHELE
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:859-300-1030
Mailing Address - Street 1:420 COLUMBIA ST # 72423
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:KY
Mailing Address - Zip Code:41071-1103
Mailing Address - Country:US
Mailing Address - Phone:859-300-1030
Mailing Address - Fax:
Practice Address - Street 1:420 COLUMBIA ST # 72423
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:KY
Practice Address - Zip Code:41071-1103
Practice Address - Country:US
Practice Address - Phone:859-300-1030
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-10
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy