Organization Active NPI

Kety Inc

  • Community/Retail Pharmacy
  • Monaca, PA
National Provider Identifier
1306861919
Registry record updated Apr 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PP415299L Issued in PA
Legal business name
KETY INC
Practice address
3589 Brodhead Rd
Monaca, PA 15061-3138
Phone
(724) 774-2990
Fax
(724) 774-6832
NPI assigned
Jul 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2017

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

Authorized official

Name
Ron McDermott
Title
SVP Operations
Phone
(330) 318-3926

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X PP415299L PA Primary

Addresses

Primary practice location

3589 Brodhead Rd
Monaca, PA 15061-3138

Mailing address

8571 Foxwood CT
Poland, OH 44514-4313
Phone (330) 318-3926

Other identifiers 2

IdentifierTypeStateIssuer
2167353OtherPK
1032785520MedicaidPA

Other names 1

  • The Hometown Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20170316000083 PA Part B Supplier - Mass Immunization (Roster Biller Only) 0042595969 Practice locations: Monaca, PA
O20170419000016 PA DME Supplier - Pharmacy 0042595969 Practice locations: Monaca, PA

National Provider Directory

National Provider Directory
Tax ID family
Kety Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3589 Brodhead Rd
Monaca, PA 15061
Phone (724) 774-2990

NPI Registry JSON

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1493337600000",
    "number": "1306861919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8571 FOXWOOD CT",
            "city": "POLAND",
            "state": "OH",
            "postal_code": "445144313",
            "telephone_number": "330-318-3926",
            "fax_number": "330-318-3927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3589 BRODHEAD RD",
            "city": "MONACA",
            "state": "PA",
            "postal_code": "150613138",
            "telephone_number": "724-774-2990",
            "fax_number": "724-774-6832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KETY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-13",
        "last_updated": "2017-04-28",
        "status": "A",
        "authorized_official_last_name": "MCDERMOTT",
        "authorized_official_first_name": "RON",
        "authorized_official_title_or_position": "SVP OPERATIONS",
        "authorized_official_telephone_number": "330-318-3926"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "PA",
            "license": "PP415299L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2167353",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1032785520",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Hometown Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Monaca, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 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.