Lally Drug Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

02166415000510 Issued in OH

Legal business name

LALLY DRUG INC

Doing business as

LALLY HEALTH MART

Practice address

23 Erie Rd
Tallmadge, OH 44278-2326

Phone

(330) 633-3239

Fax

(330) 633-0748

NPI assigned

Feb 21, 2007

Organization subpart

No

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

Authorized official

Name

Charles Lally, RPH

Title

President Ceo

Phone

(330) 631-3785

Specialties & licenses 3

Addresses

Other identifiers 3

Other names 1

• LALLY HEALTH MART Doing business as

Locations

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1195430400000",
    "number": "1922143551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 ERIE RD",
            "city": "TALLMADGE",
            "state": "OH",
            "postal_code": "442782326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 ERIE RD",
            "city": "TALLMADGE",
            "state": "OH",
            "postal_code": "442782326",
            "telephone_number": "330-633-3239",
            "fax_number": "330-633-0748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LALLY DRUG INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-21",
        "last_updated": "2007-11-19",
        "status": "A",
        "authorized_official_last_name": "LALLY",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "PRESIDENT CEO",
        "authorized_official_telephone_number": "330-631-3785",
        "authorized_official_credential": "RPH"
    },
    "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": "OH",
            "license": "02166415000510",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2719599",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER",
            "identifier": "3675658",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "3675658",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LALLY HEALTH MART",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Serif Krkic, D.C.
• Vincent Michael Krutel
• Eric Kuhn
• Kathy Lynn Kuzma, COTA/L
• Cassidy Christine Laizure
• Matilda Lamberty
• Penny Langguth, COTA/L
• James Joseph Large, D.D.S.
• Wendy Lattime, OTR/L
• Robin Lauer, CFOM, LPED

• Community/Retail Pharmacy in Tallmadge, OH
• Providers in Tallmadge, 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 Nov 19, 2007; 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.