Organization Active NPI

Ott and McHenry Pharmacy , Inc

  • Community/Retail Pharmacy
  • Bradford, PA
National Provider Identifier
1235256157
Registry record updated Mar 27, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PP411739L Issued in PA
Legal business name
OTT AND MCHENRY PHARMACY , INC
Practice address
102 Main St
Bradford, PA 16701-2023
Phone
(814) 362-3827
Fax
(814) 363-9844
NPI assigned
Mar 24, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2009

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

Authorized official

Name
Michael Dolan
Title
Owner, RPH
Phone
(814) 362-3827

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X PP411739L PA Primary

Addresses

Primary practice location

102 Main St
Bradford, PA 16701-2023

Mailing address

102 Main St
Bradford, PA 16701-2023
Phone (814) 362-3827

Other identifiers 1

IdentifierTypeStateIssuer
102152944MedicaidPA

National Provider Directory

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.

NPI Registry JSON

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

{
    "created_epoch": "1174694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1238112000000",
    "number": "1235256157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 MAIN ST",
            "city": "BRADFORD",
            "state": "PA",
            "postal_code": "167012023",
            "telephone_number": "814-362-3827",
            "fax_number": "814-363-9844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 MAIN ST",
            "city": "BRADFORD",
            "state": "PA",
            "postal_code": "167012023",
            "telephone_number": "814-362-3827",
            "fax_number": "814-363-9844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OTT AND MCHENRY PHARMACY , INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-24",
        "last_updated": "2009-03-27",
        "status": "A",
        "authorized_official_last_name": "DOLAN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER, RPH",
        "authorized_official_telephone_number": "814-362-3827"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "PA",
            "license": "PP411739L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102152944",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradford, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 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.