Martella'S Pharmacy of Ligonier, LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

MARTELLA'S PHARMACY OF LIGONIER, LLC

Practice address

113 S Fairfield St Ste 1
Ligonier, PA 15658-1163

Phone

(724) 238-6988

Fax

(724) 238-7781

NPI assigned

Jan 14, 2019

Organization subpart

No

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

Authorized official

Name

Jacqueline M. Martella, R.PH.

Title

Owner

Phone

(814) 629-1397

Specialties & licenses 2

Addresses

Other names 1

• Ligonier Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Ligonier Pharmacy, Inc.

  • Community/Retail Pharmacy
  • Ligonier, PA
  • NPI 1417945874

  O20190108001922

  Same enrollment

Locations

Practitioners 2

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

• Tracy L Davis, R.PH.

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Ligonier, PA
  • NPI 1356111363
  NPD (past)
• Brieanne McCarthy Wilcox, PHARMD

  • Pharmacist
  • Ligonier, PA
  • NPI 1073115143
  NPD (past)

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

{
    "created_epoch": "1547424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714435200000",
    "number": "1740754696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 S FAIRFIELD ST STE 1",
            "city": "LIGONIER",
            "state": "PA",
            "postal_code": "156581163",
            "telephone_number": "724-238-6988",
            "fax_number": "724-238-7781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 S FAIRFIELD ST STE 1",
            "city": "LIGONIER",
            "state": "PA",
            "postal_code": "156581163",
            "telephone_number": "724-238-6988",
            "fax_number": "724-238-7781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARTELLA'S PHARMACY OF LIGONIER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-14",
        "last_updated": "2024-04-30",
        "certification_date": "2021-12-14",
        "status": "A",
        "authorized_official_last_name": "MARTELLA",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "814-629-1397",
        "authorized_official_credential": "R.PH."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ligonier Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Beth C Lininger, PT
• Margaret M. Lockovich, SLP
• Jon R Lundquist, DDS
• Jordan Reed Lundquist, DMD
• Lee Ann Magness, CCC SLP
• Theresa Joy Matson, LSW
• Geoffrey Kurtis Mattern, D.D.S.
• Jayna Annette McIntire, MS, CCC- SLP
• David Wayne McLeary, MSPT
• Timothy J Meszar Jr., PT

• Community/Retail Pharmacy in Ligonier, PA
• Providers in Ligonier, 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 Apr 30, 2024; 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.