Overholts Champion Pharmacy Inc.

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

02649200 Issued in OH

Legal business name

OVERHOLTS CHAMPION PHARMACY INC.

Practice address

4619 Mahoning Ave.
Warren, OH 44483

Phone

(330) 847-8000

Fax

(330) 847-7708

NPI assigned

Oct 3, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Kenneth Marshall Overholt Jr., RPHNPI 1013122316

Title

President/Chief Pharmacist

Phone

(330) 847-8000

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

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

• Kenneth Marshall Overholt Jr., RPH

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

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1730273491",
    "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": "OVERHOLTS CHAMPION PHARMACY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "OVERHOLT",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "MARSHALL",
        "authorized_official_title_or_position": "PRESIDENT/CHIEF PHARMACIST",
        "authorized_official_telephone_number": "330-847-8000",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OH",
            "license": "02649200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0827118",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Orthotics & Prosthetics Rehabilitation Engineering Centre, Inc.
• Megan Osborne
• Brenda Osburn
• Stephanie Dawn Ostetrico, CNP
• Kenneth Marshall Overholt Jr., RPH
• Ashley Christine Owen, LSW
• Glenn Maurice Owens
• Marena Owens, LSW
• Barbara J Ozimek, M.A, P.C.C.
• Kristin J Pacak, AGCNS-BC

• Community/Retail Pharmacy in Warren, OH
• Providers in Warren, OH by specialty
• Community/Retail Pharmacy in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.