NPIMap

Organization Active NPI

Follansbee Pharmacy Inc

Doing business as tristate pharmacy

  • Pharmacy
  • Weirton, WV
National Provider Identifier
1083617799
Registry record updated Feb 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
SP0552308 Issued in WV
Legal business name
FOLLANSBEE PHARMACY INC
Doing business as
tristate pharmacy
Practice address
651 Colliers Way
Suite 204
Weirton, WV 26062-5053
Phone
(304) 723-6331
Fax
(304) 723-1131
NPI assigned
May 27, 2005
Last updated
Feb 18, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2020

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

Authorized official

Name
Mr. John Joseph Bernabei, RPHNPI 1417018243
Title
Owner
Phone
(304) 723-6331

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X SP0552308 WV Primary
Long Term Care Pharmacy 3336L0003X

Addresses

Primary practice location

651 Colliers Way
Suite 204
Weirton, WV 26062-5053

Mailing address

651 Colliers Way
Suite 204
Weirton, WV 26062-5053
Phone (304) 723-6331

Other identifiers 1

IdentifierTypeStateIssuer
6001347000MedicaidWV

Other names 1

  • tristate pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20090312000513 WV Part B Supplier - Mass Immunization (Roster Biller Only) 4385700509 Practice locations: Weirton, WV
O20100930066949 WV DME Supplier - Pharmacy 4385700509 Practice locations: Weirton, WV
O20200702000805 WV Part B Supplier - Pharmacy 4385700509 Practice locations: Weirton, WV

Other NPIs with the same Medicare PAC ID 2

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

National Provider Directory

National Provider Directory
Tax ID family
Follansbee Pharmacy Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1117152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581984000000",
    "number": "1083617799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "651 COLLIERS WAY",
            "address_2": "SUITE 204",
            "city": "WEIRTON",
            "state": "WV",
            "postal_code": "260625053",
            "telephone_number": "304-723-6331",
            "fax_number": "304-723-1131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "651 COLLIERS WAY",
            "address_2": "SUITE 204",
            "city": "WEIRTON",
            "state": "WV",
            "postal_code": "260625053",
            "telephone_number": "304-723-6331",
            "fax_number": "304-723-1131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOLLANSBEE PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-27",
        "last_updated": "2020-02-18",
        "certification_date": "2020-02-18",
        "status": "A",
        "authorized_official_last_name": "BERNABEI",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "304-723-6331",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "WV",
            "license": "SP0552308",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6001347000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "tristate pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "tristate pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Weirton, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2020; 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.