Active NPI
Hursh Drug Inc
Doing business as Hursh Medical
- Community/Retail Pharmacy
- Mansfield, OH
National Provider Identifier
1659457422
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- 02-0091500
- 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, 2010
- Organization subpart
- No
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4196507 | Medicaid | OH | |
| 06069 | Other | OH | PARAMONT |
| 000000155317 | Other | OH | ANTHEM BC/BS |
| 3622746 | Other | OH | NABP# |
Other names 1
- Hursh Medical
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20110107000312 | OH | Part B Supplier - Mass Immunization (Roster Biller Only) | 7012034754 | Practice locations: Mansfield, OH |
National Provider Directory
National Provider DirectoryMember 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.