NPIMap

Organization Active NPI

Southern Ohio Medical Center

Doing business as SOMC Pharmacy Waverly

  • Community/Retail Pharmacy
  • Waverly, OH
National Provider Identifier
1548037476
Registry record updated Dec 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
SOUTHERN OHIO MEDICAL CENTER
Doing business as
SOMC Pharmacy Waverly
Practice address
835 W Emmitt Ave
Waverly, OH 45690-1190
Phone
(740) 356-5813
Fax
(937) 544-5839
NPI assigned
Dec 11, 2023
Last updated
Dec 11, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
SOUTHERN OHIO MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 11, 2023

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

Authorized official

Name
Aaron Lapp
Title
Pharmacist Supervisor
Phone
(740) 356-5813

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

835 W Emmitt Ave
Waverly, OH 45690-1190

Mailing address

1805 27TH St
Portsmouth, OH 45662-2686
Phone (740) 356-5813

Other identifiers 1

IdentifierTypeStateIssuer
0232000436OtherOHOHIO BOARD OF PHARMACY LICENSE

Other names 1

  • SOMC Pharmacy Waverly Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250211000158 OH Part B Supplier - Mass Immunization (Roster Biller Only) 8325043383 Practice locations: Waverly, OH

Other NPIs with the same Medicare PAC ID 10

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

National Provider Directory

National Provider Directory
Tax ID family
Somc Discharge Pharmacy17 organizations share this tax ID, including this one
Part of
Somc Discharge Pharmacy

Other organizations with this tax ID 16

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

View all 16

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

10 Thomas Hollow Rd
Lucasville, OH 45648
Phone (740) 259-5699

8792 State Route 335
Minford, OH 45653
Phone (740) 820-2141

1121 Kinneys Ln
Portsmouth, OH 45662
Phone (740) 356-7490

1611 27th St
Ste 202
Portsmouth, OH 45662
Phone (740) 354-3344

1711 27th St
Ste 301
Portsmouth, OH 45662
Phone (740) 354-5393

1711 27th St
Ste 401
Portsmouth, OH 45662
Phone (740) 356-6837

1711 27th St
Ste 403
Portsmouth, OH 45662
Phone (740) 353-7881

1735 27th St
Ste 103
Portsmouth, OH 45662
Phone (740) 356-8257

1735 27th St
Ste 301
Portsmouth, OH 45662
Phone (740) 353-5115

1735 27th St
Ste 302
Portsmouth, OH 45662
Phone (740) 355-8562

1735 27th St
Ste 309
Portsmouth, OH 45662
Phone (740) 354-7769

1835 Oakland Ave
Portsmouth, OH 45662
Phone (740) 356-6748

723 8th St
Portsmouth, OH 45662
Phone (740) 353-5306

110 Jackson St
South Webster, OH 45682
Phone (740) 356-8681

835 W Emmitt Ave
Waverly, OH 45690
Phone (740) 356-5944

15888A US Highway 52
West Portsmouth, OH 45663
Phone (740) 858-1732

8430 Hayport Rd
Wheelersburg, OH 45694
Phone (740) 574-8189

Practitioners & affiliated clinicians

Practitioners 11

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": "1702252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702252800000",
    "number": "1548037476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1805 27TH ST",
            "city": "PORTSMOUTH",
            "state": "OH",
            "postal_code": "456622686",
            "telephone_number": "740-356-5813",
            "fax_number": "937-544-5839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "835 W EMMITT AVE",
            "city": "WAVERLY",
            "state": "OH",
            "postal_code": "456901190",
            "telephone_number": "740-356-5813",
            "fax_number": "937-544-5839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN OHIO MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOUTHERN OHIO MEDICAL CENTER",
        "enumeration_date": "2023-12-11",
        "last_updated": "2023-12-11",
        "certification_date": "2023-12-11",
        "status": "A",
        "authorized_official_last_name": "LAPP",
        "authorized_official_first_name": "AARON",
        "authorized_official_title_or_position": "PHARMACIST SUPERVISOR",
        "authorized_official_telephone_number": "740-356-5813"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OHIO BOARD OF PHARMACY LICENSE",
            "identifier": "0232000436",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SOMC Pharmacy Waverly",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Waverly, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2023; 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.