NPIMap

Organization Active NPI

Third Street Community Clinic, Inc

Doing business as Third Street Pharmacy

  • Community/Retail Pharmacy
  • Mansfield, OH
National Provider Identifier
1497485973
Registry record updated Aug 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
THIRD STREET COMMUNITY CLINIC, INC
Doing business as
Third Street Pharmacy
Practice address
600 W 3Rd St
Mansfield, OH 44906-2633
Phone
(419) 522-6191
Fax
(419) 525-6723
NPI assigned
Jun 16, 2022
Last updated
Aug 13, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
THIRD STREET COMMUNITY CLINIC, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 13, 2026

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

Authorized official

Name
Peggy Anderson
Title
Ceo
Phone
(419) 526-7880

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic Pharmacy 3336C0002X NU
Community/Retail Pharmacy 3336C0003X NU Primary
Institutional Pharmacy 3336I0012X NU
Mail Order Pharmacy 3336M0002X NU
Managed Care Organization Pharmacy 3336M0003X NU

Addresses

Primary practice location

600 W 3Rd St
Mansfield, OH 44906-2633

Mailing address

1404 Park Ave W
Ste 2
Mansfield, OH 44906-2633
Phone (419) 522-6191

Other names 1

  • Third Street Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250311002571 OH Part B Supplier - Pharmacy 2365423977 Practice locations: Mansfield, OH

Other NPIs with the same Medicare PAC ID 12

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Mansfield Family Health 224 organizations share this tax ID, including this one
Part of
Mansfield Family Health 2

Other organizations with this tax ID 23

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

View all 23

Locations

2458 Stetzer Rd
Unit A
Bucyrus, OH 44820
Phone (419) 834-8889

741 Scholl Rd
Ste A
Mansfield, OH 44907
Phone (419) 525-6737

2131 Park Ave W
#200
Ontario, OH 44906
Phone (419) 525-6730

199 W Main St
Fl 2
Shelby, OH 44875
Phone (419) 525-6732

Practitioners & affiliated clinicians

Practitioners 24

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.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1655337600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1786579200000",
    "number": "1497485973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1404 PARK AVE W",
            "address_2": "STE 2",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449062633",
            "telephone_number": "419-522-6191",
            "fax_number": "419-525-6723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 W 3RD ST",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449062633",
            "telephone_number": "419-522-6191",
            "fax_number": "419-525-6723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THIRD STREET COMMUNITY CLINIC, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "THIRD STREET COMMUNITY CLINIC, INC",
        "enumeration_date": "2022-06-16",
        "last_updated": "2026-08-13",
        "certification_date": "2026-08-13",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "PEGGY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "419-526-7880"
    },
    "taxonomies": [
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "3336I0012X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Institutional Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336M0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Mail Order Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336M0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Managed Care Organization Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Third Street Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mansfield, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.