Independent Pharmacy Group Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

INDEPENDENT PHARMACY GROUP INC

Doing business as

Bel Park Pharmacy

Practice address

602 Parmalee Ave
Ste 100
Youngstown, OH 44510-1653

Phone

(330) 746-2657

Fax

(330) 746-0014

NPI assigned

Mar 30, 2007

Last updated

Oct 5, 2007By 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

Mr. John Anthony Petracci, REG PHARMNPI 1013906361

Title

Pharmacist and Owner

Phone

(330) 746-2657

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• BEL PARK PHARMACY Doing business as

Locations

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 Anthony Petracci, R.PH

  • Pharmacist
  • Youngstown, OH
  • NPI 1013906361
  NPD Authorized official

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

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191542400000",
    "number": "1366562852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "602 PARMALEE AVE",
            "address_2": "SUITE 100",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445101653",
            "telephone_number": "330-746-2657",
            "fax_number": "330-746-0014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 PARMALEE AVE",
            "address_2": "STE 100",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445101653",
            "telephone_number": "330-746-2657",
            "fax_number": "330-746-0014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDEPENDENT PHARMACY GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-30",
        "last_updated": "2007-10-05",
        "status": "A",
        "authorized_official_last_name": "PETRACCI",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "PHARMACIST AND OWNER",
        "authorized_official_telephone_number": "330-746-2657",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "REG PHARM"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0952992",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER",
            "identifier": "3643764",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BEL PARK PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Youngstown, OH
• Providers in Youngstown, OH by specialty
• Community/Retail Pharmacy in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2007; 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.