Candlewood Pharmacy LC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

CANDLEWOOD PHARMACY LC

Doing business as

Candlewood HealthMart Pharmacy

Practice address

3254 Kimball Ave
Manhattan, KS 66503-2157

Phone

(785) 776-4100

Fax

(785) 776-1039

NPI assigned

Sep 8, 2005

Organization subpart

No

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

Authorized official

Name

Amy Hellerich, PHARMD

Title

Pic Owner

Phone

(785) 776-4100

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Candlewood HealthMart Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in KS

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Candlewood Pharmacy, LC

  dba Candlewood Health Mart Pharmacy

  • Community/Retail Pharmacy
  • Manhattan, KS
  • NPI 1770684557

  9638290265

  Same PAC ID

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Candlewood Pharmacy LC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Candlewood Pharmacy LC

  dba Candlewood Health Mart Pharmacy (LTC)

  • Long Term Care Pharmacy
  • Manhattan, KS
  • NPI 1043186802
  NPD tax ID
• Candlewood Pharmacy, LC

  dba Candlewood Health Mart Pharmacy

  • Community/Retail Pharmacy
  • Manhattan, KS
  • NPI 1770684557
  NPD tax ID

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

{
    "created_epoch": "1126137600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698105600000",
    "number": "1740274596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3254 KIMBALL AVE",
            "city": "MANHATTAN",
            "state": "KS",
            "postal_code": "665032157",
            "telephone_number": "785-776-4100",
            "fax_number": "785-776-1039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3254 KIMBALL AVE",
            "city": "MANHATTAN",
            "state": "KS",
            "postal_code": "665032157",
            "telephone_number": "785-776-4100",
            "fax_number": "785-776-1039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CANDLEWOOD PHARMACY LC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-08",
        "last_updated": "2023-10-24",
        "certification_date": "2023-10-24",
        "status": "A",
        "authorized_official_last_name": "HELLERICH",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "PIC OWNER",
        "authorized_official_telephone_number": "785-776-4100",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100325350B",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Candlewood HealthMart Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Candlewood HealthMart Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jessica Leigh Campbell, D.C.
• John L. Canady II, CRNA
• Cancer Center of Kansas PA
• Candlewood Medical Group, P.a.
• Candlewood Pharmacy LC (Candlewood Health Mart Pharmacy (LTC))
• Candlewood Pharmacy, LC (Candlewood Health Mart Pharmacy)
• Danielle Elizabeth Cannizzo
• Kathryn Canton, LMFT
• Eugene Randal Capocasale
• Kylene Caquelin, BCBA

• Durable Medical Equipment & Medical Supplies in Manhattan, KS
• Providers in Manhattan, KS by specialty
• Durable Medical Equipment & Medical Supplies in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.