NPIMap

Organization Active NPI

Klingensmith Drug Inc

Doing business as Klingensmiths Drug Stores

  • Pharmacy
  • Numine, PA
National Provider Identifier
1164437018
Registry record updated Jan 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
PP412244L Issued in PA
Legal business name
KLINGENSMITH DRUG INC
Doing business as
Klingensmiths Drug Stores
Practice address
4075 Third St
Numine, PA 16244
Phone
(724) 783-7341
Fax
(724) 783-7510
NPI assigned
Jul 29, 2006
Last updated
Jan 3, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2023

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

Authorized official

Name
Jamie Davis
Title
3Rd Party Billing Admin
Phone
(724) 763-1201

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X PP412244L PA Primary
Community/Retail Pharmacy 3336C0003X NU

Addresses

Primary practice location

4075 Third St
Numine, PA 16244

Mailing address

PO Box 151
Ford City, PA 16226-0151

Other identifiers 3

IdentifierTypeStateIssuer
1007742930026MedicaidPA
3925700OtherOTHER ID NUMBER-COMMERCIAL NUMBER
1789420MedicaidPA

Other names 1

  • KLINGENSMITHS DRUG STORES Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20090911000580 PA Part B Supplier - Mass Immunization (Roster Biller Only) 5799830964 6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Kittanning, PA; Ford City, PA; Numine, PA; New Bethlehem, PA; Leechburg, PA
O20100930033861 PA DME Supplier - Pharmacy 5799830964 Practice locations: Nu Mine, PA

Other NPIs with the same Medicare PAC ID 4

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

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Klingensmith Drug Inc11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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": "1154131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672704000000",
    "number": "1164437018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 151",
            "city": "FORD CITY",
            "state": "PA",
            "postal_code": "162260151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4075 THIRD ST",
            "city": "NUMINE",
            "state": "PA",
            "postal_code": "16244",
            "telephone_number": "724-783-7341",
            "fax_number": "724-783-7510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KLINGENSMITH DRUG INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-29",
        "last_updated": "2023-01-03",
        "certification_date": "2023-01-03",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "JAMIE",
        "authorized_official_title_or_position": "3RD PARTY BILLING ADMIN",
        "authorized_official_telephone_number": "724-763-1201"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "PA",
            "license": "PP412244L",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007742930026",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "3925700",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1789420",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "KLINGENSMITHS DRUG STORES",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "KLINGENSMITHS DRUG STORES",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Numine, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2023; 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.