NPIMap

Organization Active NPI

Minerva Pharmacy Inc

Doing business as The Medicine Shoppe

  • Community/Retail Pharmacy
  • Minerva, OH
National Provider Identifier
1295826741
Registry record updated Dec 17, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
03-2-19719 Issued in OH
Legal business name
MINERVA PHARMACY INC
Doing business as
The Medicine Shoppe
Practice address
251 East St
Minerva, OH 44657-1617
Phone
(330) 868-6200
Fax
(330) 453-7688
NPI assigned
Sep 28, 2006
Last updated
Dec 17, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2007

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

Authorized official

Name
Mrs. Andrea Evanich, R PH
Title
Pharmacist
Phone
(330) 453-4804

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 03-2-19719 OH
Community/Retail Pharmacy 3336C0003X 03-2-19719 OH Primary

Addresses

Primary practice location

251 East St
Minerva, OH 44657-1617

Mailing address

2601 Tuscarawas St W
Canton, OH 44708-4603
Phone (330) 453-4804

Other names 1

  • The Medicine Shoppe Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930064421 OH DME Supplier - PharmacyDME Supplier - Medical Supply Company With Registered Pharmacist 6709904949 Practice locations: Minerva, OH

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Minerva Pharmacy Inc251 East St, Minerva, OH 44657-1617(330) 868-6200 Immunosuppressive Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Blood Glucose Monitors/Supplies (Non-Mail Order)|Orthoses: Off-The-Shelf|Nebulizer Equipment and/or Supplies|Surgical Dressings Does not accept assignmentParticipating since Jan 1, 1998

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

2601 Tuscarawas St W
Canton, OH 44708

251 East St
Minerva, OH 44657
Phone (330) 868-6200

Practitioners & affiliated clinicians

Practitioners 2

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.

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": "1197849600000",
    "number": "1295826741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2601 TUSCARAWAS ST W",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447084603",
            "telephone_number": "330-453-4804",
            "fax_number": "330-453-7688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "251 EAST ST",
            "city": "MINERVA",
            "state": "OH",
            "postal_code": "446571617",
            "telephone_number": "330-868-6200",
            "fax_number": "330-453-7688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINERVA PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-28",
        "last_updated": "2007-12-17",
        "status": "A",
        "authorized_official_last_name": "EVANICH",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "330-453-4804",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "R PH"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "OH",
            "license": "03-2-19719",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OH",
            "license": "03-2-19719",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Medicine Shoppe",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Minerva, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.