NPIMap

Organization Active NPI

P B W Pharmacy Inc

  • Community/Retail Pharmacy
  • Canton, OH
National Provider Identifier
1265523716
Registry record updated May 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
03-3-14214 Issued in OH
Legal business name
P B W PHARMACY INC
Practice address
2526 Tuscarawas St W
Canton, OH 44708
Phone
(330) 453-4804
Fax
(330) 453-7688
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 White, R PH
Title
Vice President
Phone
(330) 455-9536

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 03-3-14214 OH
Community/Retail Pharmacy 3336C0003X 03-3-14214 OH Primary

Addresses

Primary practice location

2526 Tuscarawas St W
Canton, OH 44708

Mailing address

2523 Tuscarawas St W
Canton, OH 44708-4701
Phone (330) 455-9536

Other identifiers 2

IdentifierTypeStateIssuer
0473321MedicaidOH
3627873OtherOHNAPB

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
O20120425000824 OH Part B Supplier - Mass Immunization (Roster Biller Only) 5092832089 Practice locations: Canton, OH

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

2523 Tuscarawas St W
Canton, OH 44708

2526 Tuscarawas St W
Canton, OH 44708
Phone (330) 455-5422

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": "1159401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1527292800000",
    "number": "1265523716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2523 TUSCARAWAS ST W",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447084701",
            "telephone_number": "330-455-9536",
            "fax_number": "330-453-7688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2526 TUSCARAWAS ST W",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "44708",
            "telephone_number": "330-453-4804",
            "fax_number": "330-453-7688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "P B W 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_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": "03-3-14214",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OH",
            "license": "03-3-14214",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0473321",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NAPB",
            "identifier": "3627873",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medicine Center Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Canton, 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.