Organization Active NPI

Dartmouth Pharmacy

  • Community/Retail Pharmacy
  • Canton, OH
National Provider Identifier
1992895726
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
DARTMOUTH PHARMACY
Practice address
2801 Tuscarawas St W
Canton, OH 44708-4640
Phone
(330) 454-9045
Fax
(330) 454-3333
NPI assigned
Oct 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Mark Coberly, R.PH.
Title
President
Phone
(330) 454-9045

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X OH Primary

Addresses

Primary practice location

2801 Tuscarawas St W
Canton, OH 44708-4640

Mailing address

2801 Tuscarawas St W
Canton, OH 44708-4640
Phone (330) 454-9045

Other identifiers 1

IdentifierTypeStateIssuer
2259676MedicaidOH

National Provider Directory

National Provider Directory

Locations

2801 Tuscarawas St W
Canton, OH 44708
Phone (330) 454-9045

Practitioners & affiliated clinicians

Practitioners 1

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": "1160697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1992895726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2801 TUSCARAWAS ST W",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447084640",
            "telephone_number": "330-454-9045",
            "fax_number": "330-454-3333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 TUSCARAWAS ST W",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447084640",
            "telephone_number": "330-454-9045",
            "fax_number": "330-454-3333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DARTMOUTH PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "COBERLY",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "330-454-9045",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "R.PH."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2259676",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.