NPIMap

Organization Active NPI

Philly Pharmacy Inc

  • Community/Retail Pharmacy
  • New Philadelphia, OH
National Provider Identifier
1205927746
Registry record updated May 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
03-3-21701 Issued in OH
Legal business name
PHILLY PHARMACY INC
Practice address
551 W High Ave
New Philadelphia, OH 44663
Phone
(330) 339-4466
Fax
(330) 339-9007
NPI assigned
Sep 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 26, 2018

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

Authorized official

Name
Mr. Bradley P White, R PHNPI 1366450702
Title
Vice President
Phone
(330) 455-9536

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 03-3-21701 OH
Community/Retail Pharmacy 3336C0003X 03-3-21701 OH Primary

Addresses

Primary practice location

551 W High Ave
New Philadelphia, OH 44663

Mailing address

551 W High Ave
New Philadelphia, OH 44663-2005
Phone (330) 339-4466

Other identifiers 2

IdentifierTypeStateIssuer
3643271OtherOHNAPB
0975655MedicaidOH

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
O20100930065190 OH DME Supplier - PharmacyDME Supplier - Medical Supply CompanyDME Supplier - Medical Supply Company With Registered Pharmacist 9234259151 Practice locations: New Philadelphia, 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
36D0960791Philly Pharmacy Inc551 W High Avenue, New Philadelphia, OH 44663Certificate of waiverMay 19, 2027

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Philly Pharmacy Inc551 W High Ave, New Philadelphia, OH 44663-2005(330) 339-4466 Immunosuppressive Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|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|Nebuliz… Does not accept assignmentParticipating since Jan 1, 1998

National Provider Directory

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

551 W High Ave
New Philadelphia, OH 44663
Phone (303) 394-4663

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1527292800000",
    "number": "1205927746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "551 W HIGH AVE",
            "city": "NEW PHILADELPHIA",
            "state": "OH",
            "postal_code": "446632005",
            "telephone_number": "330-339-4466",
            "fax_number": "330-339-9007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "551 W HIGH AVE",
            "city": "NEW PHILADELPHIA",
            "state": "OH",
            "postal_code": "44663",
            "telephone_number": "330-339-4466",
            "fax_number": "330-339-9007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHILLY PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-28",
        "last_updated": "2018-05-26",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "330-455-9536",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "R PH"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "OH",
            "license": "03-3-21701",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OH",
            "license": "03-3-21701",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NAPB",
            "identifier": "3643271",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0975655",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medicine Center Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Medicine Center Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in New Philadelphia, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2018; 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.