Shane Edwin Clugston

Primary specialty

PharmacistTaxonomy code 183500000X

License

RP043511L Issued in PA

Practice address

145 N Antrim Way
Greencastle, PA 17225-1403

Phone

(717) 597-2426

Fax

(717) 597-3705

NPI assigned

Apr 17, 2025

Last updated

Apr 17, 2025By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Sovereign Covenant Pharmacy LLC

  dba Carl's Drug Store

  • Community/Retail Pharmacy
  • Greencastle, PA
  • NPI 1477556363
  NPD (past)

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

{
    "created_epoch": "1744848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744848000000",
    "number": "1942096763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 N ANTRIM WAY",
            "city": "GREENCASTLE",
            "state": "PA",
            "postal_code": "172251403",
            "telephone_number": "717-597-2426",
            "fax_number": "717-597-3705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 N ANTRIM WAY",
            "city": "GREENCASTLE",
            "state": "PA",
            "postal_code": "172251403",
            "telephone_number": "717-597-2426",
            "fax_number": "717-597-3705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLUGSTON",
        "first_name": "SHANE",
        "middle_name": "EDWIN",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-04-17",
        "last_updated": "2025-04-17",
        "certification_date": "2025-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "PA",
            "license": "RP043511L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Caitlyn Bussard, ATC, LAT
• Brooke Lindsey Carlson, M.S., CCC-SLP
• Billie Jo Cassner
• Charlie J Parsons (Greencastle Eye Care Center)
• Charlie J. Parsons (Greencastle Eye Care Center)
• Kent E Copeland, MD
• Covenant Family Dental LLC (Greencastle Family Dental)
• Ariana Cramer Langham, MSC
• Jena Helen Daihl, CRNP
• Rachael Anne Defarias, PA-C

• Pharmacist in Greencastle, PA
• Providers in Greencastle, PA by specialty
• Pharmacist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2025; 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.