Active NPI
Bentleyville Medicine Shoppe Inc
- Long Term Care Pharmacy
- Bentleyville, PA
National Provider Identifier
1497214670
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Long Term Care Pharmacy
- Legal business name
- BENTLEYVILLE MEDICINE SHOPPE INC
- Practice address
- 808 Main St
Bentleyville, PA 15314-1214 - Phone
- (724) 239-3600
- NPI assigned
- Mar 18, 2019
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- John David Crumrine
- Title
- President
- Phone
- (724) 239-3600
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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Long Term Care Pharmacy | 3336L0003X | Primary |
Addresses
Primary practice location
808 Main St
Bentleyville, PA 15314-1214
Mailing address
808 Main St
Bentleyville, PA 15314-1214
Phone (724) 239-3600
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 102979960001 | Medicaid | PA |
Other names 1
- Bentleyville Medicine Shoppe
National Provider Directory
National Provider Directory- Tax ID family
- Bentleyville Medicine Shoppe
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Community/Retail Pharmacy
- Bentleyville, PA
- NPI 1356788368
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Pharmacist
- Bentleyville, PA
- NPI 1043796824
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1552867200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1552867200000",
"number": "1497214670",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "808 MAIN ST",
"city": "BENTLEYVILLE",
"state": "PA",
"postal_code": "153141214",
"telephone_number": "724-239-3600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "808 MAIN ST",
"city": "BENTLEYVILLE",
"state": "PA",
"postal_code": "153141214",
"telephone_number": "724-239-3600"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BENTLEYVILLE MEDICINE SHOPPE INC",
"organizational_subpart": "NO",
"enumeration_date": "2019-03-18",
"last_updated": "2019-03-18",
"status": "A",
"authorized_official_last_name": "CRUMRINE",
"authorized_official_first_name": "JOHN",
"authorized_official_middle_name": "DAVID",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "724-239-3600"
},
"taxonomies": [
{
"code": "3336L0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Long Term Care Pharmacy",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "102979960001",
"state": "PA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Bentleyville Medicine Shoppe",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Bentleyville, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.