Organization Active NPI

Three Springs Village Pharmacy LLC

  • Community/Retail Pharmacy
  • Weirton, WV
National Provider Identifier
1952346397
Registry record updated Oct 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
THREE SPRINGS VILLAGE PHARMACY LLC
Practice address
204 Three Springs Dr
Ste a
Weirton, WV 26062-3815
Phone
(304) 723-2528
Fax
(304) 723-2540
NPI assigned
Jun 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2022

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

Authorized official

Name
Patsy Longhi, RPHNPI 1376665232
Title
Owner
Phone
(304) 723-2528

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 4

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Community/Retail Pharmacy 3336C0003X Primary
Compounding Pharmacy 3336C0004X
Long Term Care Pharmacy 3336L0003X SP0552329 WV

Addresses

Primary practice location

204 Three Springs Dr
Ste a
Weirton, WV 26062-3815

Mailing address

204 Three Springs Dr Ste a
Weirton, WV 26062-3815
Phone (304) 723-2528

Other identifiers 4

IdentifierTypeStateIssuer
2669134MedicaidOH
2111584OtherPK
101722700MedicaidPA
3810005765MedicaidWV

Other names 1

  • Village Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20070109000162 WV Part B Supplier - Mass Immunization (Roster Biller Only) 9638179005 Practice locations: Weirton, WV
O20100930054953 WV DME Supplier - PharmacyDME Supplier - Medical Supply Company With Registered Pharmacist 9638179005 Practice locations: Weirton, WV

National Provider Directory

National Provider Directory
Tax ID family
Three Springs Village Pharmacy LLC2 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.

Locations

204 Three Springs Dr
Ste A
Weirton, WV 26062
Phone (304) 723-2528

204 Three Springs Dr
Weirton, WV 26062

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1150675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666224000000",
    "number": "1952346397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 THREE SPRINGS DR STE A",
            "city": "WEIRTON",
            "state": "WV",
            "postal_code": "260623815",
            "telephone_number": "304-723-2528",
            "fax_number": "304-723-2540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 THREE SPRINGS DR",
            "address_2": "STE A",
            "city": "WEIRTON",
            "state": "WV",
            "postal_code": "260623815",
            "telephone_number": "304-723-2528",
            "fax_number": "304-723-2540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THREE SPRINGS VILLAGE PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-19",
        "last_updated": "2022-10-20",
        "certification_date": "2022-10-20",
        "status": "A",
        "authorized_official_last_name": "LONGHI",
        "authorized_official_first_name": "PATSY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "304-723-2528",
        "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": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "WV",
            "license": "SP0552329",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2669134",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2111584",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101722700",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810005765",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Village Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Weirton, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2022; 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.