Pope Shenouda LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

POPE SHENOUDA LLC

Practice address

10735 Ravenna Rd
Suite J
Twinsburg, OH 44087-3107

Phone

(330) 405-0501

Fax

(330) 405-0504

NPI assigned

Sep 18, 2014

Organization subpart

No

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

Authorized official

Name

Michael Moawad, RPHNPI 1780826990

Title

Pharmacy Owner

Phone

(330) 354-8990

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Twinsburg Health Mart Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michael Moawad

  • Pharmacist
  • Twinsburg, OH
  • NPI 1780826990
  NPD Authorized official

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

{
    "created_epoch": "1410998400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1439769600000",
    "number": "1083016299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10735 RAVENNA RD",
            "address_2": "SUITE J",
            "city": "TWINSBURG",
            "state": "OH",
            "postal_code": "440873107",
            "telephone_number": "330-405-0501",
            "fax_number": "330-405-0504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10735 RAVENNA RD",
            "address_2": "SUITE J",
            "city": "TWINSBURG",
            "state": "OH",
            "postal_code": "440873107",
            "telephone_number": "330-405-0501",
            "fax_number": "330-405-0504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POPE SHENOUDA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-18",
        "last_updated": "2015-08-17",
        "status": "A",
        "authorized_official_last_name": "MOAWAD",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PHARMACY OWNER",
        "authorized_official_telephone_number": "330-354-8990",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0113038",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Twinsburg Health Mart Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Amanda Jane Peto Peterson, RPH
• Diana L Phillips, LMT
• Pinnacle Chiropractic & Rehab of Twinsburg, LLC
• Pinnacle Chiropractic Health & Wellness Center, LLC
• Podiatry Inc
• Nicholas Charles Porter, RN
• Anthony Powell
• Natalie Powell, CNP
• Vincent Lamarr Powell Sr., LPN
• Psi Associates

• Community/Retail Pharmacy in Twinsburg, OH
• Providers in Twinsburg, OH by specialty
• Community/Retail Pharmacy in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2015; 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.