Wandaroo Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

021628150 Issued in OH

Legal business name

WANDAROO INC

Doing business as

The Hometown Pharmacy

Practice address

1135 W Western Reserve Rd
Poland, OH 44514-3592

Phone

(330) 629-7345

Fax

(330) 629-7353

NPI assigned

Oct 13, 2006

Organization subpart

No

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

Authorized official

Name

Ronald McDermott

Title

SVP Operations

Phone

(330) 318-3926

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• The Hometown Pharmacy Doing business as

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1489104000000",
    "number": "1811087877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8571 FOXWOOD CT",
            "address_2": "SUITE A",
            "city": "POLAND",
            "state": "OH",
            "postal_code": "445144313",
            "telephone_number": "330-318-3926",
            "fax_number": "330-318-3927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1135 W WESTERN RESERVE RD",
            "city": "POLAND",
            "state": "OH",
            "postal_code": "445143592",
            "telephone_number": "330-629-7345",
            "fax_number": "330-629-7353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WANDAROO INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-13",
        "last_updated": "2017-03-10",
        "status": "A",
        "authorized_official_last_name": "MCDERMOTT",
        "authorized_official_first_name": "RONALD",
        "authorized_official_title_or_position": "SVP OPERATIONS",
        "authorized_official_telephone_number": "330-318-3926"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OH",
            "license": "021628150",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2960005",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2080486",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Hometown Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Poland, OH
• Providers in Poland, 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 Mar 10, 2017; 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.