Bellevue Medicine Shoppe

Primary specialty

PharmacyTaxonomy code 333600000X

License

022001250 Issued in OH

Legal business name

BELLEVUE MEDICINE SHOPPE

Doing business as

Champion Medicine Shoppe

Practice address

4619 Mahoning Ave.
Warren, OH 44483

Phone

(330) 847-8000

Fax

(330) 847-7708

NPI assigned

Nov 24, 2009

Last updated

Jun 26, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Ashley Renee Dudley, PHARMD-DOCTORATE

Title

Pharmacy Manager

Phone

(330) 847-8000

Specialties & licenses 2

Addresses

Other names 1

• Champion Medicine Shoppe Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kenneth Marshall Overholt Jr., RPH

  • Pharmacist
  • Warren, OH
  • NPI 1013122316
  NPD (past)

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

{
    "created_epoch": "1259020800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1435276800000",
    "number": "1720316029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4619 MAHONING AVE.",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "44483",
            "telephone_number": "330-847-8000",
            "fax_number": "330-847-7708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4619 MAHONING AVE.",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "44483",
            "telephone_number": "330-847-8000",
            "fax_number": "330-847-7708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BELLEVUE MEDICINE SHOPPE",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-24",
        "last_updated": "2015-06-26",
        "status": "A",
        "authorized_official_last_name": "DUDLEY",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_middle_name": "RENEE",
        "authorized_official_title_or_position": "PHARMACY MANAGER",
        "authorized_official_telephone_number": "330-847-8000",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "PHARMD-DOCTORATE"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "OH",
            "license": "022001250",
            "primary": true
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Champion Medicine Shoppe",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Crystal Bell, CDCA
• Lanae Bell, LPN
• Richard Adam Bell, CRNA
• Sierra Bell
• Trevaire Bell
• Belmont Eye Clinic
• Ben Franklins Vision Center
• Fred Bencivengo, R.PH
• David Benedis Jr., LMT
• Wendy Jeanette Benigas, LSW

• Pharmacy in Warren, OH
• Providers in Warren, OH by specialty
• Pharmacy in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2015; 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.