NPIMap

Organization Active NPI

Crystal Clinic Orthopaedic Center, LLC

  • Pharmacy
  • Akron, OH
National Provider Identifier
1467979971
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
PMY02264650-03 Issued in OH
Legal business name
CRYSTAL CLINIC ORTHOPAEDIC CENTER, LLC
Practice address
444 N Main St FL 1
Akron, OH 44310-3110
Phone
(330) 379-5125
Fax
(330) 379-9086
NPI assigned
Aug 25, 2017
Last updated
Mar 7, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
CRYSTAL CLINIC ORTHOPAEDIC CENTER, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Authorized official

Name
Patricia E Walder, RPHNPI 1679146088
Title
Manager Pharmacy Operations
Phone
(330) 379-5125

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X PMY02264650-03 OH Primary

Addresses

Primary practice location

444 N Main St FL 1
Akron, OH 44310-3110

Mailing address

444 N Main St FL 1
Akron, OH 44310-3110
Phone (330) 379-5125

Other identifiers 2

IdentifierTypeStateIssuer
3685293OtherOHNCPDP
PMY-022646650-03OtherOHSTATE OF OHIO BOARD OF PHARMACY

Other names 1

  • Crystal Clinic Orthopaedic Center Outpatient Pharmacy Other name

National Provider Directory

National Provider Directory
Tax ID family
Crystal Clinic Orthopaedic Center LLC6 organizations share this tax ID, including this one
Part of
Crystal Clinic Orthopaedic Center LLC

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

444 N Main St
Fl 1
Akron, OH 44310
Phone (330) 379-5125

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1503619200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1467979971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "444 N MAIN ST FL 1",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443103110",
            "telephone_number": "330-379-5125",
            "fax_number": "330-379-9086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "444 N MAIN ST FL 1",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443103110",
            "telephone_number": "330-379-5125",
            "fax_number": "330-379-9086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRYSTAL CLINIC ORTHOPAEDIC CENTER, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CRYSTAL CLINIC ORTHOPAEDIC CENTER, LLC",
        "enumeration_date": "2017-08-25",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "WALDER",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "MANAGER PHARMACY OPERATIONS",
        "authorized_official_telephone_number": "330-379-5125",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "OH",
            "license": "PMY02264650-03",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "3685293",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF OHIO BOARD OF PHARMACY",
            "identifier": "PMY-022646650-03",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Crystal Clinic Orthopaedic Center Outpatient Pharmacy",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Akron, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.