Provider Demographics
NPI:1447442900
Name:SOPOREX RESPIRATORY II INC
Entity type:Organization
Organization Name:SOPOREX RESPIRATORY II INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:W
Authorized Official - Last Name:HEWLETT
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:270-753-5205
Mailing Address - Street 1:1308 SOUTH 12TH STREET
Mailing Address - Street 2:
Mailing Address - City:MURRAY
Mailing Address - State:KY
Mailing Address - Zip Code:42071
Mailing Address - Country:US
Mailing Address - Phone:270-753-5205
Mailing Address - Fax:270-753-9850
Practice Address - Street 1:1308 SOUTH 12TH STREET
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:KY
Practice Address - Zip Code:42071
Practice Address - Country:US
Practice Address - Phone:270-753-5205
Practice Address - Fax:270-753-9850
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SOPOREX RESPIRATORY HOLDINGS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-08-17
Last Update Date:2008-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X
KYP072043336M0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336M0002XSuppliersPharmacyMail Order Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
1830389OtherOTHER ID NUMBER
1830389OtherNCPDP
1830389OtherNCPDP