Willard Foods Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

021950600 Issued in OH

Legal business name

WILLARD FOODS INC

Doing business as

Plymouth Pharmacy

Practice address

262 Sandusky St
Plymouth, OH 44865-1151

Phone

(419) 687-5332

Fax

(419) 687-7685

NPI assigned

Nov 8, 2006

Organization subpart

No

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

Authorized official

Name

Michelle Krietemeyer, RPH

Title

Pharmacy Manager

Phone

(419) 687-5332

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• PLYMOUTH PHARMACY Doing business as

Locations

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1261094400000",
    "number": "1144390220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "262 SANDUSKY ST",
            "city": "PLYMOUTH",
            "state": "OH",
            "postal_code": "448651151",
            "telephone_number": "419-687-5332",
            "fax_number": "419-687-7685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "262 SANDUSKY ST",
            "city": "PLYMOUTH",
            "state": "OH",
            "postal_code": "448651151",
            "telephone_number": "419-687-5332",
            "fax_number": "419-687-7685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLARD FOODS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-08",
        "last_updated": "2009-12-18",
        "status": "A",
        "authorized_official_last_name": "KRIETEMEYER",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "PHARMACY MANAGER",
        "authorized_official_telephone_number": "419-687-5332",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OH",
            "license": "021950600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "3623813",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0503262",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PLYMOUTH PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jeffery Stoller
• Cierra Trotter
• Nicole Lerae Varkonda, LISW
• Village of Plymouth (Plymouth Fire Department)
• Ashley Lee Ward, STNA
• Winbigler & Zitko Optometrists LTD

• Community/Retail Pharmacy in Plymouth, OH
• Providers in Plymouth, 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 Dec 18, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.