NPIMap

Organization Active NPI

Licking Memorial Hospital

  • Community/Retail Pharmacy
  • Newark, OH
National Provider Identifier
1689458762
Registry record updated Aug 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
LICKING MEMORIAL HOSPITAL
Practice address
1272 West Main Street
Suite 401
Newark, OH 43055
Phone
(220) 564-4544
NPI assigned
Aug 21, 2023
Organization subpart
Yes
Parent organization
LICKING MEMORIAL HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 21, 2023

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

Authorized official

Name
Cynthia L Webster
Title
VP, Financial Services
Phone
(220) 564-4518

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X Primary
Specialty Pharmacy 3336S0011X

Addresses

Primary practice location

1272 West Main Street
Suite 401
Newark, OH 43055

Mailing address

1320 West Main Street
Newark, OH 43055
Phone (220) 564-4000

Other names 1

  • LMH Specialty Pharmacy Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250113002848 OH DME Supplier - Pharmacy 6204935786 Practice locations: Newark, OH

Other NPIs with the same Medicare PAC ID 3

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Licking Memorial Hospital1272 W Main St, Newark, OH 43055-2056(220) 564-2570 Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs Does not accept assignmentParticipating since Feb 21, 2024

National Provider Directory

National Provider Directory
Tax ID family
Licking Memorial Hospit6 organizations share this tax ID, including this one
Part of
Licking Memorial Hospit

Other organizations with this tax ID 5

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

Locations

1717 W Main St
Apt 102
Newark, OH 43055
Phone (220) 564-4953

1865 Tamarack Rd
Newark, OH 43055
Phone (220) 564-4972

1272 W Main St
Ste 401
Newark, OH 43055
Phone (220) 564-1750

1915 Tamarack Rd
Newark, OH 43055
Phone (220) 564-4915

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Licking Memorial HospitalNewark, OH, CCN 367475 Home health agency Operational/Managerial Control Dec 13, 2016

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1692576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692576000000",
    "number": "1689458762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1320 WEST MAIN STREET",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "43055",
            "telephone_number": "220-564-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1272 WEST MAIN STREET",
            "address_2": "SUITE 401",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "43055",
            "telephone_number": "220-564-4544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LICKING MEMORIAL HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LICKING MEMORIAL HOSPITAL",
        "enumeration_date": "2023-08-21",
        "last_updated": "2023-08-21",
        "status": "A",
        "authorized_official_last_name": "WEBSTER",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "VP, FINANCIAL SERVICES",
        "authorized_official_telephone_number": "220-564-4518"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LMH Specialty Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Newark, OH

Sources for this page

Verify at the official NPI Registry.