NPIMap

Organization Active NPI

Klingensmith Drug Inc

Doing business as Klingensmith's Drug Stores

  • Pharmacy
  • Ford City, PA
National Provider Identifier
1619944386
Registry record updated Jul 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
PP411258L Issued in PA
Legal business name
KLINGENSMITH DRUG INC
Doing business as
Klingensmith's Drug Stores
Practice address
313 Ford St
Ford City, PA 16226-1268
Phone
(724) 763-1201
Fax
(724) 763-9257
NPI assigned
Mar 2, 2006
Last updated
Jul 12, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2022

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

Authorized official

Name
Jamie Davis
Title
3Rd Party Billing Administrator
Phone
(724) 763-1201

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X PP411258L PA Primary
Community/Retail Pharmacy 3336C0003X

Addresses

Primary practice location

313 Ford St
Ford City, PA 16226-1268

Mailing address

PO Box 151
Ford City, PA 16226-0151
Phone (724) 763-1201

Other identifiers 2

IdentifierTypeStateIssuer
3917614OtherOTHER ID NUMBER-COMMERCIA
1007742930023MedicaidPA

Other names 1

  • Klingensmith's Drug Stores Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20090911000580 PA Part B Supplier - Mass Immunization (Roster Biller Only) 5799830964 6 other NPIs on this enrollment
Practice locations: Kittanning, PA; Ford City, PA; Numine, PA; New Bethlehem, PA; Leechburg, PA
O20100930090873 PA DME Supplier - Pharmacy 5799830964 Practice locations: Ford City, PA

Other NPIs with the same Medicare PAC ID 4

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

Other NPIs on the same Medicare enrollment 4

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

National Provider Directory

National Provider Directory
Tax ID family
Klingensmith Drug Inc11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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

Locations

401 Ford St
Ford City, PA 16226
Phone (724) 763-1201

NPI Registry JSON

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

{
    "created_epoch": "1141257600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657584000000",
    "number": "1619944386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 151",
            "city": "FORD CITY",
            "state": "PA",
            "postal_code": "162260151",
            "telephone_number": "724-763-1201",
            "fax_number": "724-763-9257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "313 FORD ST",
            "city": "FORD CITY",
            "state": "PA",
            "postal_code": "162261268",
            "telephone_number": "724-763-1201",
            "fax_number": "724-763-9257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KLINGENSMITH DRUG INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-02",
        "last_updated": "2022-07-12",
        "certification_date": "2022-07-12",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "JAMIE",
        "authorized_official_title_or_position": "3RD PARTY BILLING ADMINISTRATOR",
        "authorized_official_telephone_number": "724-763-1201"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "PA",
            "license": "PP411258L",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIA",
            "identifier": "3917614",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007742930023",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Klingensmith's Drug Stores",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Klingensmith's Drug Stores",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ford City, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2022; 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.