MANTUA PHARMACY INC (NPI# 1063565927) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063565927 |
| Entity Type | Organization |
| Organization Name | MANTUA PHARMACY INC |
| Other Organization Name | MANTUA STATION DRUG CO. |
| Practice Address |
10870 N. Main St Mantua OH 44255 |
| Mailing Address |
10870 N. Main St Po Box 777 Mantua OH 44255 |
| Practice Telephone | 3302742209 |
| Practice Fax Number | 3302745220 |
| Mailing Telephone | 3302742209 |
| Mailing Fax Number | 3302745220 |
| Enumeration Date | 2007-01-22 |
| Last Update Date | 2010-05-17 |
| Authorized Official Name | MR. STEVEN R WIGGERS (OWNER) |
| Authorized Official Telephone | 3302742209 |
| Authorized Official Credential | RPH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 5492800 | 05 |
| Other Name | Type Code |
|---|---|
| MANTUA STATION DRUG CO. | Doing Business As Name - Organization |
| Street Address |
10870 N. MAIN ST |
| City | MANTUA |
| State | OH |
| Zip Code | 44255 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740616820 | Cleveland Clinic Sports Health Center | Clinic/Center | 4683 Wayne Road, Mantua, OH 44255 | 2013-09-19 |
| 1801955240 | Hattie Larlham Center for Children With Disablilites | Intermediate Care Facility, Mental Illness | 9772 Diagonal Road, Mantua, OH 44255 | 2006-12-08 |
| 1780763763 | Advanced Rehabilitation and Health Specialists Inc | Physical Therapist | 4707 Mill Street, Mantua, OH 44255 | 2006-11-02 |
| 1023091774 | Emily Claire Voytilla | Optometrist | 10730 Main Street, Mantua, OH 44255 | 2005-11-28 |
| 1073015558 | Jillyan Collica | Case Manager/Care Coordinator | 3920 Lovers Lane, Ravenna, OH 44255 | 2018-03-01 |
| 1558664771 | Hattie Larlham Center for Children With Disablilites | Skilled Nursing Facility | 9772 Diagonal Road, Mantua, OH 44255 | 2010-12-09 |
| 1952530206 | Hattie Larlham Center for Children With Disablilites | Psychologist | 9772 Diagonal Road, Mantua, OH 44255 | 2009-07-08 |
| 1912179755 | Hattie Larlham Center for Children With Disablilites | Intermediate Care Facility, Mentally Retarded | 9772 Diagonal Road, Mantua, OH 44255 | 2008-04-01 |
| 1982876504 | Hattie Larlham Center for Children With Disablilites | Intermediate Care Facility, Mentally Retarded | 9772 Diagonal Road, Mantua, OH 44255 | 2008-03-25 |
| 1902011240 | Norman Joseph Sadowski | Pharmacist | 10870 Main Street, Mantua, OH 44255 | 2007-05-11 |
| Find all providers in zip 44255 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255346144 | Walgreen Co | Pharmacy | 180 Bridgeton Pike, Mantua, NJ 08051 | 2006-07-29 |
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| 1235777350 | Tan Thai Inc | Pharmacy | 4300 Clime Rd Ste 111, Columbus, OH 43228-6491 | 2019-12-19 |
| 1144868597 | Blanchard Valley Regional Health Center | Pharmacy | 930 Sheriden Dr Ste C, Carey, OH 43316-1502 | 2019-12-17 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.