NPIMap

Organization Active NPI

Mercy Professional Pharmacy

  • Community/Retail Pharmacy
  • Canton, OH
National Provider Identifier
1720176878
Registry record updated Feb 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
02-114250 Issued in OH
Legal business name
MERCY PROFESSIONAL PHARMACY
Practice address
1330 Mercy Dr NW
Canton, OH 44708-2626
Phone
(330) 489-1400
Fax
(330) 489-1175
NPI assigned
Oct 11, 2006
Organization subpart
Yes
Parent organization
MERCY MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 1, 2012

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

Authorized official

Name
Mr. Frank C Reale, RPH
Title
Pharmacist Manager
Phone
(330) 489-1400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 02-114250 OH Primary

Addresses

Primary practice location

1330 Mercy Dr NW
Canton, OH 44708-2626

Mailing address

1330 Mercy Dr NW
Canton, OH 44708-2626
Phone (330) 489-1400

Other identifiers 1

IdentifierTypeStateIssuer
0405976MedicaidOH

National Provider Directory

National Provider Directory
Tax ID family
Mercy Psychiatric Servi21 organizations share this tax ID, including this one
Part of
Mercy Psychiatric Servi

Other organizations with this tax ID 20

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

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1328054400000",
    "number": "1720176878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1330 MERCY DR NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447082626",
            "telephone_number": "330-489-1400",
            "fax_number": "330-489-1175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 MERCY DR NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447082626",
            "telephone_number": "330-489-1400",
            "fax_number": "330-489-1175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY PROFESSIONAL PHARMACY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MERCY MEDICAL CENTER",
        "enumeration_date": "2006-10-11",
        "last_updated": "2012-02-01",
        "status": "A",
        "authorized_official_last_name": "REALE",
        "authorized_official_first_name": "FRANK",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PHARMACIST MANAGER",
        "authorized_official_telephone_number": "330-489-1400",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OH",
            "license": "02-114250",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0405976",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.