NPIMap

Organization Active NPI

John Manchin III

  • Community/Retail Pharmacy
  • Farmington, WV
National Provider Identifier
1326122060
Registry record updated Jul 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
SPO552200 Issued in WV
Legal business name
JOHN MANCHIN III
Doing business as
THE DRUG STORE
Practice address
1021 Main St
Farmington, WV 26571
Phone
(304) 825-1270
Fax
(304) 825-1196
NPI assigned
Oct 25, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2014

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

Authorized official

Name
John Manchin, B.S.
Title
Owner
Phone
(304) 825-6554

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X SPO552200 WV Primary

Addresses

Primary practice location

1021 Main St
Farmington, WV 26571

Mailing address

PO Box 597
Farmington, WV 26571-0597

Other identifiers 2

IdentifierTypeStateIssuer
0141691000MedicaidWV
2111318OtherPK

Other names 1

  • THE DRUG STORE Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1405987200000",
    "number": "1326122060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 597",
            "city": "FARMINGTON",
            "state": "WV",
            "postal_code": "265710597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1021 MAIN ST",
            "city": "FARMINGTON",
            "state": "WV",
            "postal_code": "26571",
            "telephone_number": "304-825-1270",
            "fax_number": "304-825-1196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN MANCHIN III",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-25",
        "last_updated": "2014-07-22",
        "status": "A",
        "authorized_official_last_name": "MANCHIN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "304-825-6554",
        "authorized_official_credential": "B.S."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "WV",
            "license": "SPO552200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0141691000",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2111318",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "THE DRUG STORE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Farmington, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2014; 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.