Bentleyville Medicine Shoppe Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PP482389 Issued in PA

Legal business name

BENTLEYVILLE MEDICINE SHOPPE INC

Doing business as

Bentleyville Medicine Shoppe

Practice address

808 Main St
Bentleyville, PA 15314-1214

Phone

(724) 239-3600

Fax

(724) 239-3601

NPI assigned

May 30, 2013

Last updated

Mar 17, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

John D CrumrineNPI 1043796824

Title

President

Phone

(724) 239-3600

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Bentleyville Medicine Shoppe Doing business as

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Tax ID family

Bentleyville Medicine Shoppe2 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.

• Bentleyville Medicine Shoppe Inc

  dba Bentleyville Medicine Shoppe

  • Long Term Care Pharmacy
  • Bentleyville, PA
  • NPI 1497214670
  NPD tax ID

Practitioners 1

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.

• John David Crumrine

  • Pharmacist
  • Bentleyville, PA
  • NPI 1043796824
  NPD Authorized official

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

{
    "created_epoch": "1369872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1552780800000",
    "number": "1356788368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "808 MAIN ST",
            "city": "BENTLEYVILLE",
            "state": "PA",
            "postal_code": "153141214",
            "telephone_number": "724-239-3600",
            "fax_number": "724-239-3601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "808 MAIN ST",
            "city": "BENTLEYVILLE",
            "state": "PA",
            "postal_code": "153141214",
            "telephone_number": "724-239-3600",
            "fax_number": "724-239-3601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BENTLEYVILLE MEDICINE SHOPPE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-30",
        "last_updated": "2019-03-17",
        "status": "A",
        "authorized_official_last_name": "CRUMRINE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "724-239-3600"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "PA",
            "license": "PP482389",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102979600001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bentleyville Medicine Shoppe",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• George Phillip Anderson, RPH
• Sheila Marie Anderson, DO
• Bentleyville Chiropractic Center
• Bentleyville Medicine Shoppe Inc (Bentleyville Medicine Shoppe)
• Bentleyville Sedation Dentistry PC
• Bentworth Ambulance Service Inc
• Bentworth School District
• Erica Bonelli

• Community/Retail Pharmacy in Bentleyville, PA
• Providers in Bentleyville, PA by specialty
• Community/Retail Pharmacy in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2019; 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.