NPIMap

Organization Active NPI

Klingensmith Drug Inc

  • Pharmacy
  • Leechburg, PA
National Provider Identifier
1073528923
Registry record updated Mar 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
PP413324L Issued in PA
Legal business name
KLINGENSMITH DRUG INC
Practice address
117 3Rd St Ste a
Leechburg, PA 15656-1215
Phone
(724) 845-7501
Fax
(724) 845-7818
NPI assigned
Jul 29, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Jamie Davis
Title
3Rd Party Billing Admin
Phone
(724) 763-1201

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X PP413324L PA Primary
Community/Retail Pharmacy 3336C0003X

Addresses

Primary practice location

117 3Rd St Ste a
Leechburg, PA 15656-1215

Mailing address

PO Box 151
Ford City, PA 16226-0151

Other identifiers 3

IdentifierTypeStateIssuer
1007742930017MedicaidPA
3930270OtherOTHER ID NUMBER-COMMERCIAL NUMBER
561101MedicaidPA

Other names 1

  • KLINGENSMITHS DRUG STORES Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20090911000580 PA Part B Supplier - Mass Immunization (Roster Biller Only) 5799830964 6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Kittanning, PA; Ford City, PA; Numine, PA; New Bethlehem, PA; Leechburg, PA
O20100930090874 PA DME Supplier - PharmacyDME Supplier - Medical Supply Company With Registered Pharmacist 5799830964 Practice locations: Leechburg, PA

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Klingensmith Drug Inc11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

Locations

401 Ford St
Ford City, PA 16226
Phone (724) 763-1201

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616457600000",
    "number": "1073528923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 151",
            "city": "FORD CITY",
            "state": "PA",
            "postal_code": "162260151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 3RD ST STE A",
            "city": "LEECHBURG",
            "state": "PA",
            "postal_code": "156561215",
            "telephone_number": "724-845-7501",
            "fax_number": "724-845-7818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KLINGENSMITH DRUG INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-29",
        "last_updated": "2021-03-23",
        "certification_date": "2021-03-23",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "JAMIE",
        "authorized_official_title_or_position": "3RD PARTY BILLING ADMIN",
        "authorized_official_telephone_number": "724-763-1201"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "PA",
            "license": "PP413324L",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007742930017",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "3930270",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "561101",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "KLINGENSMITHS DRUG STORES",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "KLINGENSMITHS DRUG STORES",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Leechburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.