Minerva Pharmacy Inc

Organization Active NPI Community/Retail Pharmacy · Minerva, OH

NPI 1295826741 · NPPES record last updated Dec 17, 2007

Key facts

NPI
1295826741
Entity type
Organization (NPI type 2)
Primary specialty
Community/Retail Pharmacy 3336C0003X
License
03-2-19719 (OH)
Legal business name
MINERVA PHARMACY INC
Practice address
251 East St
Minerva, OH 44657-1617
Phone
(330) 868-6200
Fax
(330) 453-7688
NPI assigned
Sep 28, 2006
Organization subpart
No

Authorized official

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

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.

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Laboratory certificates & supplier records

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

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Minerva Pharmacy Inc
251 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 assignment
Participating since Jan 1, 1998

Medicare participation

Medicare fee-for-service enrollment
Enrolled in OH

Medicare enrollment records

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

National Provider Directory

Locations

2601 Tuscarawas St W
Canton, OH 44708

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

Specialties & licenses

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

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 identifiers

IdentifierTypeStateIssuer
3656292OtherOHNAPB
0853901MedicaidOH

Other names

  • The Medicine Shoppe Doing business as

Other providers in Minerva, OH

All providers in Minerva, OH · Community/Retail Pharmacy in Ohio

Sources for this page

Verify at the official NPI Registry.