Sloandale Enterprises

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PP482649 Issued in PA

Legal business name

SLOANDALE ENTERPRISES

Doing business as

The Medicine Shoppe Pharmacy

Practice address

206 S Martin St
Titusville, PA 16354-1851

Phone

(814) 827-1849

Fax

(814) 827-0220

NPI assigned

Nov 30, 2015

Organization subpart

No

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

Authorized official

Name

Clyde Willey

Title

Owner

Phone

(814) 827-1849

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• The Medicine Shoppe Pharmacy Doing business as

Locations

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

{
    "created_epoch": "1448841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476921600000",
    "number": "1720452824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 S MARTIN ST",
            "city": "TITUSVILLE",
            "state": "PA",
            "postal_code": "163541851",
            "telephone_number": "814-827-1849",
            "fax_number": "814-827-0220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 S MARTIN ST",
            "city": "TITUSVILLE",
            "state": "PA",
            "postal_code": "163541851",
            "telephone_number": "814-827-1849",
            "fax_number": "814-827-0220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SLOANDALE ENTERPRISES",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-30",
        "last_updated": "2016-10-20",
        "status": "A",
        "authorized_official_last_name": "WILLEY",
        "authorized_official_first_name": "CLYDE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "814-827-1849"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "PA",
            "license": "PP482649",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103112999",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2159091",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Medicine Shoppe Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Scott a Kennedy OD PC
• Shanley J Seybert, D.C.
• Chungja C Shim
• Maria Elaine Shreffler
• John Patrick Slater, PHARMD, BCPS
• Eugene A Snyder Jr., PA
• William Robert Sonnenberg, MD
• Stairways Behavioral Health
• Krista L Stearns, LPC
• Samantha Steffy

• Community/Retail Pharmacy in Titusville, PA
• Providers in Titusville, PA by specialty
• Community/Retail Pharmacy in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2016; 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.