Hermitage Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PP412447L Issued in PA

Legal business name

HERMITAGE PHARMACY LLC

Doing business as

Hermitage Pharmacy
The Medicine Shoppe Pharmacy

Practice address

1740 E State St
Hermitage, PA 16148-1862

Phone

(724) 983-8451

Fax

(724) 983-0918

NPI assigned

Sep 30, 2006

Last updated

Oct 20, 2025By 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

Bretton Clark Walberg, RPHNPI 1659809374

Title

Member

Phone

(724) 612-2131

Specialties & licenses 4

Addresses

Other identifiers 3

Other names 2

• Hermitage Pharmacy Doing business as
• The Medicine Shoppe Pharmacy Doing business as

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

CLIA laboratory certificates

Locations

Practitioners 4

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.

• Bretton Clark Walberg, RPH

  • Pharmacist
  • Greenville, PA
  • NPI 1659809374
  Authorized official Same address or phone
• Donna Garland

  • Pharmacist
  • Hermitage, PA
  • NPI 1104014844
  NPD (past)
• Paul Scott Vaughn, RPH

  • Pharmacist
  • Hermitage, PA
  • NPI 1649947060
  NPD (past)
• Devon Marie Yokubeak, PHARMD

  • Pharmacist
  • Hermitage, PA
  • NPI 1609464833
  NPD (past)

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

{
    "created_epoch": "1159574400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1760918400000",
    "number": "1407949852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 CONNEAUT LAKE ROAD",
            "city": "GREENVILLE",
            "state": "PA",
            "postal_code": "161252167",
            "telephone_number": "724-612-2131",
            "fax_number": "724-983-0918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1740 E STATE ST",
            "city": "HERMITAGE",
            "state": "PA",
            "postal_code": "161481862",
            "telephone_number": "724-983-8451",
            "fax_number": "724-983-0918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERMITAGE PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-30",
        "last_updated": "2025-10-20",
        "certification_date": "2025-10-20",
        "status": "A",
        "authorized_official_last_name": "WALBERG",
        "authorized_official_first_name": "BRETTON",
        "authorized_official_middle_name": "CLARK",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "724-612-2131",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "PA",
            "license": "PP412447L",
            "primary": true
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104547785-0001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2083437",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1023278440002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hermitage Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "The Medicine Shoppe Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Hermitage Endoscopy Center Inc
• Hermitage Eye & Laser Center (Joseph Eye & Laser Center)
• Hermitage Internal Medicine Group
• Hermitage Neurology PC
• Hermitage Orthopedics and Sports Medicine, P.C.
• Emily Sara Herold
• Teresa H. Hessmann, LCSW
• Hickory Hills Family Denal
• Clyde H Hoffman, MSW, LCSW
• Melinda L. Hogue, MSW, LCSW

• Community/Retail Pharmacy in Hermitage, PA
• Providers in Hermitage, 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 Oct 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.