Wandaroo Inc

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

Legal business name

WANDAROO INC

Practice address

1135 W Western Reserve Rd
Poland, OH 44514-3592

Phone

(330) 629-7345

Fax

(330) 629-7353

NPI assigned

May 29, 2020

Organization subpart

No

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

Authorized official

Name

Ronald T McDermott, RPH

Title

SVP Operations

Phone

(330) 318-3926

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• The Hometown Pharmacy Long Term Care Doing business as

Electronic endpoints 1

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

{
    "created_epoch": "1590710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1659571200000",
    "number": "1376167908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8571 FOXWOOD CT STE A",
            "city": "POLAND",
            "state": "OH",
            "postal_code": "445144313",
            "telephone_number": "330-318-3926",
            "fax_number": "330-318-3927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1135 W WESTERN RESERVE RD",
            "city": "POLAND",
            "state": "OH",
            "postal_code": "445143592",
            "telephone_number": "330-629-7345",
            "fax_number": "330-629-7353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WANDAROO INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-29",
        "last_updated": "2022-08-04",
        "certification_date": "2022-08-04",
        "status": "A",
        "authorized_official_last_name": "MCDERMOTT",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "SVP OPERATIONS",
        "authorized_official_telephone_number": "330-318-3926",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2960005",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "www.thehometownpharmacies.com",
            "affiliation": "N",
            "endpointDescription": "Website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "contentOtherDescription": "web",
            "address_1": "1135 W Western Reserve Rd",
            "city": "Poland",
            "state": "OH",
            "country_code": "US",
            "postal_code": "445143592",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "The Hometown Pharmacy Long Term Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Long Term Care Pharmacy in Poland, OH
• Providers in Poland, OH by specialty
• Long Term Care Pharmacy in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2022; 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.