Knisley Pharmacy Limited
Organization Active NPI Community/Retail Pharmacy · Bainbridge, OH
NPI 1194735720 · NPPES record last updated Feb 20, 2017
Key facts
- NPI
- 1194735720
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- RTP021350050 (OH)
- Legal business name
- KNISLEY PHARMACY LIMITED
- Practice address
- 115 E Main St
Bainbridge, OH 45612-1102 - Phone
- (740) 634-3231
- Fax
- (740) 634-3236
- NPI assigned
- Aug 8, 2006
- Organization subpart
- No
Authorized official
- Name
- Casey McFadden, RPH
- Title
- Owner,Pic,Ao
- Phone
- (740) 634-3231
Practitioners 1
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 36D2154597 | McFadden Pharmacy | Certificate of waiver | Sep 16, 2026 |
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| McFadden Pharmacy |
Nebulizer Drugs|Commodes, Urinals, Bedpans|Blood Glucose Monitors/Supplies (Non-Mail Order)|Support Surfaces: Pressure Reducing Beds/Mats/Pads|Canes and/or Crutches|Walkers|Wheelchairs (Standard Manual)|Wheelchairs (Standard Manual Related Accessories)|Orthoses: Off-The-Shelf|Ostomy Supplies|Urolog… | Does not accept assignment |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in OH
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040819001476 | OH | Part B Supplier - Mass Immunization (Roster Biller Only) | 4789658444 | Practice locations: Bainbridge, OH |
| O20100930095615 | OH | DME Supplier - Pharmacy | 4789658444 | Practice locations: Bainbridge, OH |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | RTP021350050 | OH | Yes |
Addresses
Primary practice location
115 E Main St
Bainbridge, OH 45612-1102
Mailing address
PO Box 566
Bainbridge, OH 45612-0566
Phone (740) 634-3231
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2075490 | Other | PK | |
| 2378743 | Medicaid | OH |
Other names
- MCFADDEN PHARMACY
Other providers in Bainbridge, OH
- Kacy Lynn-Marie Juanchi
- Deneal Kimball
- Rosalie Renae King
- Jamie Kingery
- Logan Joseph Knauff
- Paul Koehler
- Kenneth Kuhns
- Jessica Lynn Kunkel
- Taylor Larkin
- Joshua Leach
All providers in Bainbridge, OH · Community/Retail Pharmacy in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 20, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.