Active NPI
Medina Family Pharmacy LLC
- Community/Retail Pharmacy
- Medina, OH
National Provider Identifier
1669213385
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- Legal business name
- MEDINA FAMILY PHARMACY LLC
- Practice address
- 3705 Medina Rd Ste C
Medina, OH 44256-6616 - Phone
- (330) 486-8396
- Fax
- (888) 905-4906
- NPI assigned
- Jun 5, 2024
- 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
- Dr. John Komara III, PHARMD
- Title
- Owner/President
- Phone
- (304) 868-3963
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | Primary | ||
| Compounding Pharmacy | 3336C0004X |
Addresses
Primary practice location
3705 Medina Rd Ste C
Medina, OH 44256-6616
Mailing address
3705 Medina Rd Ste C
Medina, OH 44256-6616
Phone (330) 486-8396
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20240910002495 | OH | Part B Supplier - Pharmacy | 2668912254 | Practice locations: Medina, OH |
National Provider Directory
National Provider DirectoryLocations
3705 Medina Rd
Ste C
Medina, OH 44256
Phone (330) 486-8396
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Pharmacist
- Medina, OH
- NPI 1477093698
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1717545600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1721692800000",
"number": "1669213385",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3705 MEDINA RD STE C",
"city": "MEDINA",
"state": "OH",
"postal_code": "442566616",
"telephone_number": "330-486-8396",
"fax_number": "888-905-4906"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3705 MEDINA RD STE C",
"city": "MEDINA",
"state": "OH",
"postal_code": "442566616",
"telephone_number": "330-486-8396",
"fax_number": "888-905-4906"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MEDINA FAMILY PHARMACY LLC",
"organizational_subpart": "NO",
"enumeration_date": "2024-06-05",
"last_updated": "2024-07-23",
"certification_date": "2024-07-23",
"status": "A",
"authorized_official_last_name": "KOMARA",
"authorized_official_first_name": "JOHN",
"authorized_official_title_or_position": "OWNER/PRESIDENT",
"authorized_official_telephone_number": "304-868-3963",
"authorized_official_name_prefix": "Dr.",
"authorized_official_name_suffix": "III",
"authorized_official_credential": "PHARMD"
},
"taxonomies": [
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": null,
"license": null,
"primary": true
},
{
"code": "3336C0004X",
"taxonomy_group": "",
"desc": "Pharmacy, Compounding Pharmacy",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Medina, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2024; 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.