NPIMap

Organization Active NPI

Memorial Hospital

Doing business as Memorial Hospital Pharmacy

  • Institutional Pharmacy
  • Fremont, OH
National Provider Identifier
1306960513
Registry record updated Apr 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Institutional PharmacyTaxonomy code 3336I0012X
License
HOS.020030100-03 Issued in OH
Legal business name
MEMORIAL HOSPITAL
Doing business as
Memorial Hospital Pharmacy
Practice address
715 S Taft Ave
Fremont, OH 43420-3237
Phone
(419) 334-6618
Fax
(419) 334-6678
NPI assigned
Mar 16, 2007
Last updated
Apr 19, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2016

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

Authorized official

Name
Randal Koch, RPH
Title
Pharmacy Director
Phone
(419) 334-6618

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Institutional Pharmacy 3336I0012X HOS.020030100-03 OH Primary

Addresses

Primary practice location

715 S Taft Ave
Fremont, OH 43420-3237

Mailing address

715 S Taft Ave
Fremont, OH 43420-3237
Phone (419) 334-6618

Other identifiers 1

IdentifierTypeStateIssuer
2075169OtherPK

Other names 1

  • MEMORIAL HOSPITAL PHARMACY Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Memorial Hospital3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

NPI Registry JSON

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

{
    "created_epoch": "1174003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461024000000",
    "number": "1306960513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 S TAFT AVE",
            "city": "FREMONT",
            "state": "OH",
            "postal_code": "434203237",
            "telephone_number": "419-334-6618",
            "fax_number": "419-334-6678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 S TAFT AVE",
            "city": "FREMONT",
            "state": "OH",
            "postal_code": "434203237",
            "telephone_number": "419-334-6618",
            "fax_number": "419-334-6678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-16",
        "last_updated": "2016-04-19",
        "status": "A",
        "authorized_official_last_name": "KOCH",
        "authorized_official_first_name": "RANDAL",
        "authorized_official_title_or_position": "PHARMACY DIRECTOR",
        "authorized_official_telephone_number": "419-334-6618",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336I0012X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Institutional Pharmacy",
            "state": "OH",
            "license": "HOS.020030100-03",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2075169",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MEMORIAL HOSPITAL PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fremont, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2016; 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.