NPIMap

Organization Active NPI

Medicine Shoppe 1088 LLC

  • Long Term Care Pharmacy
  • Bucyrus, OH
National Provider Identifier
1255932349
Registry record updated Apr 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
Legal business name
MEDICINE SHOPPE 1088 LLC
Doing business as
Medicine Shoppe 1088 LTC
Practice address
345 N Sandusky Ave
Bucyrus, OH 44820-1806
Phone
(419) 562-4222
NPI assigned
Nov 4, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2025

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

Authorized official

Name
Tamer IbrahimNPI 1457641896
Title
President
Phone
(330) 412-7442

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
Community/Retail Pharmacy 3336C0003X
Long Term Care Pharmacy 3336L0003X Primary

Addresses

Primary practice location

345 N Sandusky Ave
Bucyrus, OH 44820-1806

Mailing address

345 N Sandusky Ave
Bucyrus, OH 44820-1806

Other names 1

  • Medicine Shoppe 1088 LTC Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Medicine Shoppe 10882 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

345 N Sandusky Ave
Bucyrus, OH 44820
Phone (419) 562-4222

Practitioners & affiliated clinicians

Practitioners 3

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": "1604448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744502400000",
    "number": "1255932349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "345 N SANDUSKY AVE",
            "city": "BUCYRUS",
            "state": "OH",
            "postal_code": "448201806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 N SANDUSKY AVE",
            "city": "BUCYRUS",
            "state": "OH",
            "postal_code": "448201806",
            "telephone_number": "419-562-4222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICINE SHOPPE 1088 LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-04",
        "last_updated": "2025-04-13",
        "certification_date": "2025-04-13",
        "status": "A",
        "authorized_official_last_name": "IBRAHIM",
        "authorized_official_first_name": "TAMER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "330-412-7442"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medicine Shoppe 1088 LTC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bucyrus, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2025; 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.