NPIMap

Organization Active NPI

Louisville Pharmacy Inc

Doing business as Medicine Center Pharmacy

  • Community/Retail Pharmacy
  • Louisville, OH
National Provider Identifier
1114021177
Registry record updated May 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
020557650 Issued in OH
Legal business name
LOUISVILLE PHARMACY INC
Doing business as
Medicine Center Pharmacy
Practice address
700 W Main St
Louisville, OH 44641-1338
Phone
(330) 875-5525
Fax
(330) 875-9798
NPI assigned
Sep 12, 2006
Last updated
May 1, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 1, 2017

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

Authorized official

Name
Brad White, B.S
Title
Vice President
Phone
(330) 339-4466

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU
Pharmacy 333600000X NU
Community/Retail Pharmacy 3336C0003X 020557650 OH Primary

Addresses

Primary practice location

700 W Main St
Louisville, OH 44641-1338

Mailing address

2523 Tuscarawas St W
Canton, OH 44708-4701
Phone (330) 453-4804

Other identifiers 2

IdentifierTypeStateIssuer
0713660MedicaidOH
2070772OtherPK

Other names 1

  • Medicine Center Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930026545 OH DME Supplier - PharmacyDME Supplier - Medical Supply Company With Registered Pharmacist 8527186766 Practice locations: Louisville, OH

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
36D0960795Louisville Pharmacy Inc700 W Main Street, Louisville, OH 44641Certificate of waiverMay 19, 2027

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Louisville Pharmacy Inc700 W Main St, Louisville, OH 44641-1338(330) 875-5525 Commodes, Urinals, Bedpans|Blood Glucose Monitors/Supplies (Non-Mail Order)|Canes and/or Crutches|Seat Lift Mechanisms|Walkers|Orthoses: Off-The-Shelf|Ostomy Supplies|Tracheotomy Supplies|Urological Supplies|Nebulizer Equipment and/or Supplies|Surgical Dressings Does not accept assignmentParticipating since Jan 1, 1998

National Provider Directory

National Provider Directory
Tax ID family
Louisville Pharmacy Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Member of 3

Organizations this organization is a member of, according to the National Provider Directory.

Member organizations 3

Organizations listed as members of this organization in the National Provider Directory.

Locations

700 W Main St
Louisville, OH 44641
Phone (330) 499-9847

Practitioners & affiliated clinicians

Practitioners 7

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": "1158019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1493596800000",
    "number": "1114021177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2523 TUSCARAWAS ST W",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447084701",
            "telephone_number": "330-453-4804",
            "fax_number": "330-453-7688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 W MAIN ST",
            "city": "LOUISVILLE",
            "state": "OH",
            "postal_code": "446411338",
            "telephone_number": "330-875-5525",
            "fax_number": "330-875-9798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOUISVILLE PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-12",
        "last_updated": "2017-05-01",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "BRAD",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "330-339-4466",
        "authorized_official_credential": "B.S"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OH",
            "license": "020557650",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0713660",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2070772",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medicine Center Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Louisville, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.