Third Street Community Clinic, Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

THIRD STREET COMMUNITY CLINIC, INC

Practice address

31 E Main St
Shelby, OH 44875-1262

Phone

(419) 525-6729

Fax

(419) 730-3590

NPI assigned

Sep 11, 2026

Organization subpart

Yes

Parent organization

THIRD STREET COMMUNITY CLINIC, INCAs reported in NPPES

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

Authorized official

Name

Peggy Anderson

Title

Chief Executive Officer

Phone

(419) 526-7880

Specialties & licenses 5

Addresses

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

{
    "created_epoch": "1789084800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1789084800000",
    "number": "1144130071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1404 PARK AVE W STE 2",
            "city": "ONTARIO",
            "state": "OH",
            "postal_code": "449062719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 E MAIN ST",
            "city": "SHELBY",
            "state": "OH",
            "postal_code": "448751262",
            "telephone_number": "419-525-6729",
            "fax_number": "419-730-3590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THIRD STREET COMMUNITY CLINIC, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "THIRD STREET COMMUNITY CLINIC, INC",
        "enumeration_date": "2026-09-11",
        "last_updated": "2026-09-11",
        "certification_date": "2026-09-11",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "PEGGY",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "419-526-7880"
    },
    "taxonomies": [
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336I0012X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Institutional Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336M0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Mail Order Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336M0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Managed Care Organization Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Stacy S Thomas, LPN
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• Jenny Lynne Thurman, RD,LD
• Allison Tomasek
• Virgilio Millado Tongson, MD

• Community/Retail Pharmacy in Shelby, OH
• Providers in Shelby, 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 Sep 11, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.