Shadyside Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

020132300 Issued in OH

Legal business name

SHADYSIDE PHARMACY INC

Doing business as

The Shadyside Pharmacy

Practice address

3948 Central Avenue
Shadyside, OH 43947-1310

Phone

(740) 676-4782

Fax

(740) 676-4914

NPI assigned

Dec 27, 2006

Last updated

Mar 7, 2023By 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

Mr. Rodney David Fithen, RPH

Title

Pharmacist

Phone

(740) 676-4782

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• The Shadyside Pharmacy Doing business as

Locations

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

{
    "created_epoch": "1167177600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1487719654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3948 CENTRAL AVENUE",
            "city": "SHADYSIDE",
            "state": "OH",
            "postal_code": "439471310",
            "telephone_number": "740-676-4782",
            "fax_number": "740-676-4914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3948 CENTRAL AVENUE",
            "city": "SHADYSIDE",
            "state": "OH",
            "postal_code": "439471310",
            "telephone_number": "740-676-4782",
            "fax_number": "740-676-4914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHADYSIDE PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-27",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "FITHEN",
        "authorized_official_first_name": "RODNEY",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "740-676-4782",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OH",
            "license": "020132300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0276197",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Shadyside Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Professional Dental Alliance of Shadyside, LLC
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• Shadyside Local School District
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• Jeffrey Shallcross
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• Stephanie Lynn Strope, MSW, LGSW
• Melinda Ann Turner
• Lindsay Twarog, NP-C

• Community/Retail Pharmacy in Shadyside, OH
• Providers in Shadyside, OH by specialty
• Community/Retail Pharmacy in Ohio

• 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.