Organization Active NPI

Hursh Drug Inc

Doing business as Hursh Medical

  • Community/Retail Pharmacy
  • Mansfield, OH
National Provider Identifier
1659457422
Registry record updated Oct 7, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
02-0091500 Issued in OH
Legal business name
HURSH DRUG INC
Doing business as
Hursh Medical
Practice address
90 N Diamond St
Mansfield, OH 44902-1325
Phone
(419) 524-0521
Fax
(419) 524-3892
NPI assigned
Oct 27, 2006
Last updated
Oct 7, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2010

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

Authorized official

Name
Mr. Robert Harley Knowlton, RPH
Title
President
Phone
(419) 524-0521

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU
Parenteral & Enteral Nutrition Supplies (DME) 332BP3500X NU
Oxygen Equipment & Supplies (DME) 332BX2000X NU
Community/Retail Pharmacy 3336C0003X 02-0091500 OH Primary

Addresses

Primary practice location

90 N Diamond St
Mansfield, OH 44902-1325

Mailing address

90 N Diamond St
Mansfield, OH 44902-1325
Phone (419) 524-0521

Other identifiers 4

IdentifierTypeStateIssuer
4196507MedicaidOH
06069OtherOHPARAMONT
000000155317OtherOHANTHEM BC/BS
3622746OtherOHNABP#

Other names 1

  • Hursh Medical Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110107000312 OH Part B Supplier - Mass Immunization (Roster Biller Only) 7012034754 Practice locations: Mansfield, OH

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1286409600000",
    "number": "1659457422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 N DIAMOND ST",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449021325",
            "telephone_number": "419-524-0521",
            "fax_number": "419-524-3892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 N DIAMOND ST",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449021325",
            "telephone_number": "419-524-0521",
            "fax_number": "419-524-3892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HURSH DRUG INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-27",
        "last_updated": "2010-10-07",
        "status": "A",
        "authorized_official_last_name": "KNOWLTON",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "HARLEY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "419-524-0521",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OH",
            "license": "02-0091500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4196507",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PARAMONT",
            "identifier": "06069",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC/BS",
            "identifier": "000000155317",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NABP#",
            "identifier": "3622746",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hursh Medical",
            "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 Oct 7, 2010; 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.