Churchills Perrysburg LTD

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

021949950 Issued in OH

Legal business name

CHURCHILLS PERRYSBURG LTD

Doing business as

Walt Churchill's Market

Practice address

26625 Dixie Hwy
Perrysburg, OH 43551-1712

Phone

(419) 872-6904

Fax

(419) 872-6917

NPI assigned

Dec 18, 2006

Last updated

Jan 18, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kimberly Johnson, RPHNPI 1811588965

Title

Pharmacy Manager,Pic,Ao

Phone

(419) 872-6904

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Walt Churchill's Market Doing business as

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kimberly Kay Johnson, RPH

  • Pharmacist
  • Perrysburg, OH
  • NPI 1811588965
  NPD Authorized official

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484697600000",
    "number": "1265595888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26625 DIXIE HWY",
            "city": "PERRYSBURG",
            "state": "OH",
            "postal_code": "435511712",
            "telephone_number": "419-872-6904",
            "fax_number": "419-872-6917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26625 DIXIE HWY",
            "city": "PERRYSBURG",
            "state": "OH",
            "postal_code": "435511712",
            "telephone_number": "419-872-6904",
            "fax_number": "419-872-6917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHURCHILLS PERRYSBURG LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-18",
        "last_updated": "2017-01-18",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "PHARMACY MANAGER,PIC,AO",
        "authorized_official_telephone_number": "419-872-6904",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OH",
            "license": "021949950",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2119661",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0051914",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Walt Churchill's Market",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lap Pan Chu, PHARMD
• Amber Chuhy
• Victoria Chung
• Caroline Chupurdy
• Jasmine L Church, LPCC, LICDC
• Douglas I Cifuentes, D.O.
• Circle of Care Supportive Services
• CKC Medical Inc (Perrysburg Home Medical Equipment)
• Christopher B Clark, DDS
• Madeline Elizabeth Clark, LPC

• Community/Retail Pharmacy in Perrysburg, OH
• Providers in Perrysburg, OH by specialty
• Community/Retail Pharmacy in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2017; 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.