Titusville Ms LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

TITUSVILLE MS LLC

Doing business as

Medicine Shoppe

Practice address

329 W Central Ave
Titusville, PA 16354-1642

Phone

(814) 827-1849

Fax

(814) 827-0220

NPI assigned

Dec 7, 2007

Last updated

Mar 7, 2023By 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

Edward M Derrick

Title

Owner

Phone

(814) 827-1849

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Medicine Shoppe Doing business as

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.

• Patricia Anne L'Huillier, RPH

  • Pharmacist
  • Titusville, PA
  • NPI 1942579164
  NPD (past)

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

{
    "created_epoch": "1196985600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1265615603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "329 W CENTRAL AVE",
            "city": "TITUSVILLE",
            "state": "PA",
            "postal_code": "163541642",
            "telephone_number": "814-827-1849",
            "fax_number": "814-827-0220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "329 W CENTRAL AVE",
            "city": "TITUSVILLE",
            "state": "PA",
            "postal_code": "163541642",
            "telephone_number": "814-827-1849",
            "fax_number": "814-827-0220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TITUSVILLE MS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-07",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "DERRICK",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "814-827-1849"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "PA",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1020774380001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP #",
            "identifier": "3989487",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medicine Shoppe",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Allysia Tommelleo, RN
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• Community/Retail Pharmacy in Titusville, PA
• Providers in Titusville, PA by specialty
• Community/Retail Pharmacy in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.