Aultman Hospital
Organization Active NPI Community/Retail Pharmacy · Canton, OH
NPI 1700941978 · NPPES record last updated Mar 16, 2020
Key facts
- NPI
- 1700941978
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- PMY02142810003 (OH)
- Legal business name
- AULTMAN HOSPITAL
- Practice address
- 2600 6TH St SW
Canton, OH 44710-1702 - Phone
- (330) 363-5489
- Fax
- (330) 363-5837
- NPI assigned
- Dec 27, 2006
- Organization subpart
- No
Authorized official
- Name
- Thomas Casey, BS
- Title
- Pharmacist Manager
- Phone
- (330) 363-5489
Owned or controlled facilities with NPI records 1
Other NPIs with the same Medicare PAC ID 6
Corporate family (same tax ID) 13
Practitioners 175
-
Mirza N Ahmad, MD
-
Ashish Angl, M.D.
-
Raffi Bardakjian, MD
-
Chadi Elias Bou Serhal, M.D., M.S.
-
Nihad M Boutros, M.D.
-
Brett A Butler, MD
-
Michael Carpenter, CNP
-
Manova David, M.D
-
Laura Elizabeth Fenn, CNP
-
Kristen E Fliger, APRN-CNP
-
Nicholas Gotschall, APRN-CNP
-
Todd L Johnson, M.D.
-
George H Kefalas, M.D.
-
Rachel Kennen, CNP
-
Matthew Fitzgerald Knoch, M.D.
-
Peter Kometiani, MD PHD
-
Gina Maria Ludwig, MSN, APRN, NP-C
-
Jennifer Adele Lute, CNP
-
Brent Victor Martinez, M.D.
-
Eyad Nashawati, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
All facility ownership & control disclosures 1
| Facility | Type | Role | Since |
|---|---|---|---|
| Aultman Hospital Health Care in Your Home |
Home health agency | 5% Or Greater Direct Ownership Interest (100%) | Jan 1, 2001 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20220802003352 | OH | DME Supplier - Pharmacy | 3779485867 | Practice locations: Canton, OH |
National Provider Directory
- Tax ID family
- Hugh M Pratt
Locations
2600 6th St SW
Fl 1
Canton, OH 44710
Phone (330) 363-1410
2600 6th St SW
Ste A2
Canton, OH 44710
2732 Fulton Dr NW
Canton, OH 44718
2600 7th St SW
Canton, OH 44710
Phone (330) 363-6242
2912 Tuscarawas St W
Canton, OH 44708
Phone (330) 458-0150
4638 Hills and Dales Rd NW
Canton, OH 44708
Phone (330) 363-2536
2051 Wales Ave NW
Ste 100
Massillon, OH 44646
Phone (330) 363-7462
1228 Market St NE
Navarre, OH 44662
Phone (330) 879-5952
517 Park St NW
Ste A
Navarre, OH 44662
Phone (330) 791-7791
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | PMY02142810003 | OH | Yes |
Addresses
Primary practice location
2600 6TH St SW
Canton, OH 44710-1702
Mailing address
2600 6TH St SW
Canton, OH 44710-1702
Phone (330) 363-5489
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2079881 | Other | PK | |
| 2501420 | Medicaid | OH |
Other names
- AULTMAN EMPLOYEE PHARMACY
Other providers in Canton, OH
- Aultman Hospital
- Aultman Hospital
- Aultman Hospital
- Aultman Hospital
- Aultman Hospital
- Aultman Hospital
- Aultman Hospital
- Aultman Hospital
- Aultman Medical Group, Inc
- Aultman Pharmacy Inc
All providers in Canton, OH · Community/Retail Pharmacy in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 16, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.