NPIMap

Organization Active NPI

Samaritan LTC Pharmacy

  • Pharmacist
  • Trotwood, OH
National Provider Identifier
1588717268
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
Legal business name
SAMARITAN LTC PHARMACY
Practice address
4750 Salem Ave
Trotwood, OH 45416-1714
Phone
(937) 567-3406
Fax
(937) 341-8875
NPI assigned
Jan 18, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Jim Pancoast
Title
Ceo
Phone
(937) 567-3406

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PharmacistGroup: 193400000X SINGLE SPECIALTY GROUP 183500000X OH Primary

Addresses

Primary practice location

4750 Salem Ave
Trotwood, OH 45416-1714

Mailing address

4750 Salem Ave
Trotwood, OH 45416-1714
Phone (937) 567-3406

National Provider Directory

National Provider Directory
Tax ID family
Good Samaritan Hospital Health Center4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

4750 Salem Ave
Trotwood, OH 45416
Phone (937) 567-3406

NPI Registry JSON

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1588717268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4750 SALEM AVE",
            "city": "TROTWOOD",
            "state": "OH",
            "postal_code": "454161714",
            "telephone_number": "937-567-3406",
            "fax_number": "937-341-8875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4750 SALEM AVE",
            "city": "TROTWOOD",
            "state": "OH",
            "postal_code": "454161714",
            "telephone_number": "937-567-3406",
            "fax_number": "937-341-8875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMARITAN LTC PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PANCOAST",
        "authorized_official_first_name": "JIM",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "937-567-3406"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Trotwood, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.