Five Star Pharmacy

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

FIVE STAR PHARMACY

Doing business as

Shady Spring Pharmacy

Practice address

2795 Ritter Dr
Shady Spring, WV 25918-8515

Phone

(304) 573-1114

NPI assigned

Oct 17, 2019

Last updated

Oct 17, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Leslie Diane Sisson, RPHNPI 1366692782

Title

Co-Owner

Phone

(304) 573-1114

Specialties & licenses 1

Addresses

Other names 1

• Shady Spring Pharmacy Doing business as

Locations

Practitioners 2

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.

• Leslie Diane Sisson, RPH

  • Pharmacist
  • Shady Spring, WV
  • NPI 1366692782
  NPD Authorized official
• Amy B Jamison, RPH

  • Pharmacist
  • Shady Spring, WV
  • NPI 1306483813
  NPD

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

{
    "created_epoch": "1571270400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1571270400000",
    "number": "1972146314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2795 RITTER DR",
            "city": "SHADY SPRING",
            "state": "WV",
            "postal_code": "259188515",
            "telephone_number": "304-573-1114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2795 RITTER DR",
            "city": "SHADY SPRING",
            "state": "WV",
            "postal_code": "259188515",
            "telephone_number": "304-573-1114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIVE STAR PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-17",
        "last_updated": "2019-10-17",
        "status": "A",
        "authorized_official_last_name": "SISSON",
        "authorized_official_first_name": "LESLIE",
        "authorized_official_middle_name": "DIANE",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "304-573-1114",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shady Spring Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jordyn Dilly
• Angela Douglas, DDS
• Dreama Short Counseling Services
• Tammy Farley
• Cassandra N Farmer
• Claudia Gillispie
• Lyndsay Gross
• Sheila Hall Harman
• Cynthia Lynn Harford, LPC
• Carol Harvey, NP

• Community/Retail Pharmacy in Shady Spring, WV
• Providers in Shady Spring, WV by specialty
• Community/Retail Pharmacy in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2019; 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.