NPIMap

Organization Active NPI

Schwietermans Drug Store Inc

Doing business as Schwieterman Pharmacy

  • Community/Retail Pharmacy
  • Minster, OH
National Provider Identifier
1528088119
Registry record updated Dec 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
02598000 Issued in OH
Legal business name
SCHWIETERMANS DRUG STORE INC
Doing business as
Schwieterman Pharmacy
Practice address
324 N Main St
Minster, OH 45865-9560
Phone
(419) 628-2305
Fax
(419) 628-2119
NPI assigned
Jul 19, 2006
Last updated
Dec 9, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2016

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

Authorized official

Name
Mark DominikNPI 1720080757
Title
Pres
Phone
(419) 629-2336

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X NU
Community/Retail Pharmacy 3336C0003X 02598000 OH Primary

Addresses

Primary practice location

324 N Main St
Minster, OH 45865-9560

Mailing address

324 N Main St
Minster, OH 45865-9560
Phone (419) 628-2305

Other identifiers 2

IdentifierTypeStateIssuer
0847203MedicaidOH
2072067OtherPK

Other names 1

  • SCHWIETERMAN PHARMACY Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040923000925 OH Part B Supplier - Mass Immunization (Roster Biller Only) 4981672250 5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Minster, OH; Wapakoneta, OH; New Bremen, OH; Coldwater, OH

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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": "1153267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1481241600000",
    "number": "1528088119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "324 N MAIN ST",
            "city": "MINSTER",
            "state": "OH",
            "postal_code": "458659560",
            "telephone_number": "419-628-2305",
            "fax_number": "419-628-2119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "324 N MAIN ST",
            "city": "MINSTER",
            "state": "OH",
            "postal_code": "458659560",
            "telephone_number": "419-628-2305",
            "fax_number": "419-628-2119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCHWIETERMANS DRUG STORE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-19",
        "last_updated": "2016-12-09",
        "status": "A",
        "authorized_official_last_name": "DOMINIK",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "PRES",
        "authorized_official_telephone_number": "419-629-2336"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OH",
            "license": "02598000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0847203",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2072067",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SCHWIETERMAN PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Minster, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2016; 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.