Organization Active NPI

Pastm Inc

  • Pharmacy
  • Huntington, WV
National Provider Identifier
1467546770
Registry record updated Aug 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
SP0552277 Issued in WV
Legal business name
PASTM INC
Doing business as
MEDICAP PHARMACY
Practice address
4352 5TH Street Rd
Huntington, WV 25701-9558
Phone
(304) 523-5003
Fax
(304) 523-2462
NPI assigned
Oct 3, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2008

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

Authorized official

Name
Peter Thomas, RPHNPI 1710270970
Title
Pharmacist
Phone
(304) 523-5003

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X SP0552277 WV Primary
Community/Retail Pharmacy 3336C0003X

Addresses

Primary practice location

4352 5TH Street Rd
Huntington, WV 25701-9558

Mailing address

4352 5TH Street Rd
Huntington, WV 25701-9558
Phone (304) 523-5003

Other identifiers 2

IdentifierTypeStateIssuer
6004009000MedicaidWV
5011894OtherOTHER ID NUMBER-COMMERCIAL NUMBER

Other names 1

  • MEDICAP PHARMACY Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100930057455 WV DME Supplier - Pharmacy 9638382856 Practice locations: Huntington, WV
O20121106000004 WV Part B Supplier - Mass Immunization (Roster Biller Only) 9638382856 Practice locations: Huntington, WV

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.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
51D1039777Medicap Pharmacy 3174352 Fifth Street Road, Huntington, WV 25701Certificate of waiverApr 21, 2027

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Medicap Pharmacy4352 5TH Street Rd, Huntington, WV 25701-9558(304) 523-5003 Blood Glucose Monitors/Supplies (Non-Mail Order)|Ostomy Supplies Accepts assignmentParticipating since Mar 1, 2002

National Provider Directory

National Provider Directory

Locations

4352 5th Street Rd
Huntington, WV 25701
Phone (304) 523-5003

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218153600000",
    "number": "1467546770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4352 5TH STREET RD",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257019558",
            "telephone_number": "304-523-5003",
            "fax_number": "304-523-2462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4352 5TH STREET RD",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257019558",
            "telephone_number": "304-523-5003",
            "fax_number": "304-523-2462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PASTM INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2008-08-08",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "PETER",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "304-523-5003",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "WV",
            "license": "SP0552277",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6004009000",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "5011894",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MEDICAP PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Huntington, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2008; 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.