Provider Demographics
NPI:1548810757
Name:CHEWY PHARMACY LLC
Entity type:Organization
Organization Name:CHEWY PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP
Authorized Official - Prefix:DR
Authorized Official - First Name:JUSTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLS
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:502-215-6911
Mailing Address - Street 1:11403 BLUEGRASS PKWY STE 650
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40299-2398
Mailing Address - Country:US
Mailing Address - Phone:502-267-1131
Mailing Address - Fax:
Practice Address - Street 1:11403 BLUEGRASS PKWY STE 650
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40299-2398
Practice Address - Country:US
Practice Address - Phone:877-977-3879
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-19
Last Update Date:2019-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336M0002XSuppliersPharmacyMail Order Pharmacy