NPIMap

Organization Active NPI

Southern Ohio Medical Center

  • Community/Retail Pharmacy
  • Wheelersburg, OH
National Provider Identifier
1366816043
Registry record updated Mar 31, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PMY.022572900-03 Issued in OH
Legal business name
SOUTHERN OHIO MEDICAL CENTER
Practice address
8770 Ohio River Rd
Wheelersburg, OH 45694-1918
Phone
(740) 574-8933
Fax
(740) 356-7898
NPI assigned
Nov 18, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2017

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

Authorized official

Name
Rory Phillips
Title
Director of Pharmacy/Respiratory SE
Phone
(740) 574-8933

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X PMY.022572900-03 OH Primary

Addresses

Primary practice location

8770 Ohio River Rd
Wheelersburg, OH 45694-1918

Mailing address

1805 27TH St
Portsmouth, OH 45662-2640
Phone (740) 356-8193

Other identifiers 2

IdentifierTypeStateIssuer
0153224MedicaidOH
2155191OtherPK

Other names 1

  • SOMC Pharmacy Wheelersburg Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20180530001384 OH DME Supplier - Pharmacy 8325043383 Practice locations: Wheelersburg, OH
O20190108003380 OH Part B Supplier - Mass Immunization (Roster Biller Only) 8325043383 Practice locations: Wheelersburg, OH

Other NPIs with the same Medicare PAC ID 10

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Southern Ohio Medical Center8770 Ohio River Rd, Wheelersburg, OH 45694-1918(740) 355-4120 Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs Accepts assignmentParticipating since Sep 1, 2016

National Provider Directory

National Provider Directory
Tax ID family
Somc Pharmacy Wheelersburg17 organizations share this tax ID, including this one

Other organizations with this tax ID 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1447804800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490918400000",
    "number": "1366816043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1805 27TH ST",
            "city": "PORTSMOUTH",
            "state": "OH",
            "postal_code": "456622640",
            "telephone_number": "740-356-8193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8770 OHIO RIVER RD",
            "city": "WHEELERSBURG",
            "state": "OH",
            "postal_code": "456941918",
            "telephone_number": "740-574-8933",
            "fax_number": "740-356-7898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN OHIO MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-18",
        "last_updated": "2017-03-31",
        "status": "A",
        "authorized_official_last_name": "PHILLIPS",
        "authorized_official_first_name": "RORY",
        "authorized_official_title_or_position": "DIRECTOR OF PHARMACY/RESPIRATORY SE",
        "authorized_official_telephone_number": "740-574-8933"
    },
    "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": "PMY.022572900-03",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0153224",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2155191",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SOMC Pharmacy Wheelersburg",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wheelersburg, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.