Active NPI
Wedgewood Pharmacy
- Community/Retail Pharmacy
- Austintown, OH
National Provider Identifier
1841831831
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- Legal business name
- WEDGEWOOD PHARMACY
- Practice address
- 4350 New Rd
Austintown, OH 44515-4501 - Phone
- (330) 799-2503
- Fax
- (330) 259-9616
- NPI assigned
- Oct 1, 2019
- Last updated
- May 11, 2025
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Brad Patrick Vaughn, RPH
- Title
- Owner
- Phone
- (330) 799-2503
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | Primary |
Addresses
Primary practice location
4350 New Rd
Austintown, OH 44515-4501
Mailing address
4350 New Rd
Austintown, OH 44515-4501
Phone (330) 799-2503
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0376213 | Medicaid | OH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20200610000821 | OH | Part B Supplier - Mass Immunization (Roster Biller Only) | 8123449527 | Practice locations: Austintown, OH |
National Provider Directory
National Provider Directory- Tax ID family
- Wedgewood Pharmacy
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Long Term Care Pharmacy
- Austintown, OH
- NPI 1750148128
Locations
4350 New Rd
Youngstown, OH 44515
Phone (330) 799-2503
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Pharmacist
- Austintown, OH
- NPI 1215947551
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1569888000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1746921600000",
"number": "1841831831",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4350 NEW RD",
"city": "AUSTINTOWN",
"state": "OH",
"postal_code": "445154501",
"telephone_number": "330-799-2503",
"fax_number": "330-259-9616"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4350 NEW RD",
"city": "AUSTINTOWN",
"state": "OH",
"postal_code": "445154501",
"telephone_number": "330-799-2503",
"fax_number": "330-259-9616"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WEDGEWOOD PHARMACY",
"organizational_subpart": "NO",
"enumeration_date": "2019-10-01",
"last_updated": "2025-05-11",
"certification_date": "2025-05-11",
"status": "A",
"authorized_official_last_name": "VAUGHN",
"authorized_official_first_name": "BRAD",
"authorized_official_middle_name": "PATRICK",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "330-799-2503",
"authorized_official_credential": "RPH"
},
"taxonomies": [
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0376213",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Austintown, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2025; 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.