SHPH LLC
Organization Active NPI Community/Retail Pharmacy · Shepherdstown, WV
NPI 1033417530 · NPPES record last updated Dec 21, 2022
Key facts
- NPI
- 1033417530
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- SP0552417 (WV)
- Legal business name
- SHPH LLC
- Practice address
- 7670 Martinsburg Pike
#2
Shepherdstown, WV 25443-3698 - Phone
- (304) 876-9966
- Fax
- (304) 876-6655
- NPI assigned
- Mar 7, 2011
- Organization subpart
- No
Authorized official
- Name
- Kristine Renee Knott
- Title
- Owner Pharmd
- Phone
- (304) 876-9966
Practitioners 4
-
Kristine Renee Knott, PHARMD
-
Jordan Lee Davis, PHARMD
-
Sarah Knipe, PHARMD
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 51D2024077 | Shepherdstown Pharmacy | Certificate of waiver | May 8, 2027 |
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| SHPH LLC |
Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Commodes, Urinals, Bedpans|Blood Glucose Monitors/Supplies (Non-Mail Order)|Heat & Cold Applications|Infrared Heating Pads Systems and/or Supplies|Insulin Infusion Pumps and/or Supplies|Canes … | Does not accept assignment |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in WV
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20111130000890 | WV | DME Supplier - Pharmacy |
1052585080 | Practice locations: Shepherdstown, WV |
| O20120124000419 | WV | Part B Supplier - Mass Immunization (Roster Biller Only) | 1052585080 | Practice locations: Shepherdstown, WV |
National Provider Directory
Locations
7670 Martinsburg Pike
Ste 2
Shepherdstown, WV 25443
Phone (304) 876-9966
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | SP0552417 | WV | Yes |
Addresses
Primary practice location
7670 Martinsburg Pike
#2
Shepherdstown, WV 25443-3698
Mailing address
7670 Martinsburg Pike
#2
Shepherdstown, WV 25443-3698
Phone (304) 876-9966
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5055430 | Other | NCPDP PROVIDER IDENTIFICATION NUMBER | |
| 3810020224 | Medicaid | WV |
Other names
- Shepherdstown Pharmacy
Other providers in Shepherdstown, WV
- Sheena Marie Santana
- Aniya Saunders-Moseley
- Teresa Ray Sheets
- Ashley Shepard
- Shepherdstown Fire Department
- Mary Shugrue
- Shannon Sine
- Taylor Sines
- Skyline Wound Care PLLC
- Kristen Elizabeth Smialek
All providers in Shepherdstown, WV · Community/Retail Pharmacy in West Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 21, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.