Medicine Shoppe 1018 LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

020936300 Issued in OH

Legal business name

MEDICINE SHOPPE 1018 LLC

Practice address

900 E Main St
Lancaster, OH 43130-4048

Phone

(740) 653-7779

Fax

(740) 653-8265

NPI assigned

Dec 4, 2006

Organization subpart

No

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

Authorized official

Name

Tamer Ibrahim

Title

President

Phone

(330) 412-7442

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Medicine shoppe 1018 Doing business as

Medicare fee-for-service enrollment

Enrolled in OH2 enrollments

Enrollment records 2

Tax ID family

Chillicothe RX Support Services Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Medicine Shoppe 1018 LLC

  • Long Term Care Pharmacy
  • Lancaster, OH
  • NPI 1639964208
  NPD tax ID

Practitioners 1

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

• Tracy Johnson

  • Pharmacist
  • Lancaster, OH
  • NPI 1568745446
  NPD (past)

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1584057600000",
    "number": "1871651828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 E MAIN ST",
            "city": "LANCASTER",
            "state": "OH",
            "postal_code": "431304048",
            "telephone_number": "740-653-7779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 E MAIN ST",
            "city": "LANCASTER",
            "state": "OH",
            "postal_code": "431304048",
            "telephone_number": "740-653-7779",
            "fax_number": "740-653-8265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICINE SHOPPE 1018 LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-04",
        "last_updated": "2020-03-13",
        "certification_date": "2020-03-13",
        "status": "A",
        "authorized_official_last_name": "IBRAHIM",
        "authorized_official_first_name": "TAMER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "330-412-7442"
    },
    "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": "020936300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0340229",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medicine shoppe 1018",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Meals on Wheels Older Adult Alternatives of Fairfield County, Inc.
• Meandering Grace
• Medical Associates of Lancaster
• Medical Spa NP LLC
• Medicine Shoppe 1018 LLC
• Michael S Medina
• William L. Medved, D.D.S.
• Meijer Stores Limited Partnership
• Joyce Ann Melick, LPN
• Hollie Merchant, LMT

• Community/Retail Pharmacy in Lancaster, OH
• Providers in Lancaster, 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 13, 2020; 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.