NPIMap

Organization Active NPI

Southern Ohio Medical Center

Doing business as Somc Pharmacy West Union

  • Community/Retail Pharmacy
  • West Union, OH
National Provider Identifier
1386059228
Registry record updated Mar 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
RTP02242430003 Issued in OH
Legal business name
SOUTHERN OHIO MEDICAL CENTER
Doing business as
Somc Pharmacy West Union
Practice address
90 Cic Blvd
West Union, OH 45693-8024
Phone
(937) 544-8989
Fax
(937) 544-5839
NPI assigned
Jun 30, 2014
Last updated
Mar 8, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2017

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

Authorized official

Name
Rory Phillips
Title
Admin Director of Pharmacy
Phone
(740) 356-8193

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X RTP02242430003 OH Primary

Addresses

Primary practice location

90 Cic Blvd
West Union, OH 45693-8024

Mailing address

90 Cic Blvd
West Union, OH 45693-8024
Phone (937) 544-8989

Other identifiers 2

IdentifierTypeStateIssuer
2146607OtherPK
0108488MedicaidOH

Other names 1

  • SOMC PHARMACY WEST UNION Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20141202002221 OH DME Supplier - Pharmacy 8325043383 Practice locations: West Union, OH
O20150611002406 OH Part B Supplier - Mass Immunization (Roster Biller Only) 8325043383 Practice locations: West Union, 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 Center90 Cic Blvd, West Union, OH 45693-8024(937) 544-8989 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 Discharge Pharmacy17 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": "1404086400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488931200000",
    "number": "1386059228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 CIC BLVD",
            "city": "WEST UNION",
            "state": "OH",
            "postal_code": "456938024",
            "telephone_number": "937-544-8989",
            "fax_number": "937-544-5839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 CIC BLVD",
            "city": "WEST UNION",
            "state": "OH",
            "postal_code": "456938024",
            "telephone_number": "937-544-8989",
            "fax_number": "937-544-5839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN OHIO MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-30",
        "last_updated": "2017-03-08",
        "status": "A",
        "authorized_official_last_name": "PHILLIPS",
        "authorized_official_first_name": "RORY",
        "authorized_official_title_or_position": "ADMIN DIRECTOR OF PHARMACY",
        "authorized_official_telephone_number": "740-356-8193"
    },
    "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": "RTP02242430003",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2146607",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0108488",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SOMC PHARMACY WEST UNION",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in West Union, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 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.