Organization Active NPI

Span & Taylor Drug Co

  • Community/Retail Pharmacy
  • Monongahela, PA
National Provider Identifier
1730294661
Registry record updated Jan 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PP412352L Issued in PA
Legal business name
SPAN & TAYLOR DRUG CO
Practice address
175 W Main St
Monongahela, PA 15063-2305
Phone
(724) 258-4545
NPI assigned
Aug 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2021

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

Authorized official

Name
Kristopher Francis MarchewkaNPI 1144774696
Title
Pharmacist
Phone
(724) 258-4545

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X PP412352L PA Primary

Addresses

Primary practice location

175 W Main St
Monongahela, PA 15063-2305

Mailing address

175 W Main St
Monongahela, PA 15063-2305
Phone (724) 258-4545

Other identifiers 1

IdentifierTypeStateIssuer
0012381660001MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210126000449 PA Part B Supplier - Pharmacy 9133245897 Practice locations: Monongahela, PA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1610496000000",
    "number": "1730294661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 W MAIN ST",
            "city": "MONONGAHELA",
            "state": "PA",
            "postal_code": "150632305",
            "telephone_number": "724-258-4545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 W MAIN ST",
            "city": "MONONGAHELA",
            "state": "PA",
            "postal_code": "150632305",
            "telephone_number": "724-258-4545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPAN & TAYLOR DRUG CO",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-20",
        "last_updated": "2021-01-13",
        "certification_date": "2021-01-13",
        "status": "A",
        "authorized_official_last_name": "MARCHEWKA",
        "authorized_official_first_name": "KRISTOPHER",
        "authorized_official_middle_name": "FRANCIS",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "724-258-4545"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "PA",
            "license": "PP412352L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0012381660001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Monongahela, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.