Ohio Northern University
Organization Active NPI Pharmacy · Ada, OH
NPI 1437668183 · NPPES record last updated Jul 21, 2022
Key facts
- NPI
- 1437668183
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Pharmacy 333600000X
- Legal business name
- OHIO NORTHERN UNIVERSITY
- Practice address
- 511 W Lincoln Ave
Ada, OH 45810 - Phone
- (419) 772-3784
- Fax
- (419) 772-3783
- NPI assigned
- Sep 26, 2017
- Organization subpart
- Yes
- Parent organization (as reported)
- -
Authorized official
- Name
- Katie Westgerdes, R.PH.
- Title
- Manager of Pharmacy Services
- Phone
- (419) 772-2659
Practitioners 11
-
Amanda J Fordyce, PHARMD RPH
-
Kaitlyn Brooke Kirby, PHARMD
-
Luke Austin Klinehoffer, PHARM D
-
Brittany Long, PHARMD
-
Kyle Parker, R.PH.
-
Michael James Rush, PHARMD, CDE
-
Katie Lee Westgerdes, PHARMD
-
Jasmine Andrea Duarte, PHARMD
-
Alaina Kortokrax, RPH
-
Natalie Hall, PHARMD
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 36D1004472 | Ohio Northern University Raabe | Certificate of waiver | Sep 26, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20180201003017 | OH | Part B Supplier - Pharmacy | 9537429998 | Practice locations: Ada, OH |
National Provider Directory
- Part of
- Ohio Northern University
Locations
511 W Lincoln Ave
Ada, OH 45810
Phone (419) 772-2299
525 S Main St
Ada, OH 45810
Phone (419) 604-3372
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | Yes | ||
| Community/Retail Pharmacy | 3336C0003X | 022816750 | OH |
Addresses
Primary practice location
511 W Lincoln Ave
Ada, OH 45810
Mailing address
525 S Main St
Ada, OH 45810-6000
Phone (419) 772-3784
Other practice location 1
525 S Main St
Ada, OH 45810-6000
Phone (419) 772-2319
Other practice location 2
525 S Main St
Ada, OH 45810
Phone (419) 772-2319
Other names
- ONU HealthWise Pharmacy
Other providers in Ada, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.