CHAMPION DISCOUNT PHARMACY, LLC (NPI# 1275906554) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275906554 |
| Entity Type | Organization |
| Organization Name | CHAMPION DISCOUNT PHARMACY, LLC |
| Other Organization Name | CHAMPION DISCOUNT PHARMACY |
| Practice Address |
4299 Mahoning Ave Nw Warren OH 44483-1928 |
| Practice Telephone | 3303069616 |
| Mailing Telephone | 2348063137 |
| Mailing Fax Number | 2348063138 |
| Enumeration Date | 2015-11-09 |
| Last Update Date | 2016-11-17 |
| Authorized Official Name | EDWARD TING (MEMBER, LLC) |
| Authorized Official Telephone | 3302193005 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | Suppliers | ||
| N | 3336C0004X |
Pharmacy Specialization: Compounding Pharmacy |
Suppliers | ||
| N | 3336L0003X |
Pharmacy Specialization: Long Term Care Pharmacy |
Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 0150213 | 05 | |
| PK | 2154953 | 01 |
| Other Name | Type Code |
|---|---|
| Champion Discount Pharmacy | Doing Business As Name - Organization |
| Street Address |
4299 MAHONING AVE NW |
| City | WARREN |
| State | OH |
| Zip Code | 44483-1928 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417419177 | Lindsay Ann Coulter | Pharmacist | 4299 Mahoning Ave Nw, Warren, OH 44483-1928 | 2019-04-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417572850 | Kimberly Lee Slater | Peer Specialist | 709 Mahoning Ave Nw, Warren, OH 44483 | 2020-06-11 |
| 1083239792 | Krutarth Kandarp Pandya | Student in an Organized Health Care Education/Training Program | 1350 East Market Street 7th Floor, Warren, OH 44483 | 2020-06-09 |
| 1902435738 | Peter Alexander Iskander | Student in an Organized Health Care Education/Training Program | 1350 E Market Street, 7th Floor, Warren, OH 44483 | 2020-04-03 |
| 1093344822 | Matthew Jacob | Student in an Organized Health Care Education/Training Program | 1350 East Market Street, 7th Floor, Warren, OH 44483 | 2020-04-03 |
| 1306309638 | Sameer Raj Joshi | Student in an Organized Health Care Education/Training Program | 1350 East Market Street, Warren, OH 44483 | 2019-04-12 |
| 1336619964 | Alexis Valentino | Nurse Practitioner | 247 Oak Knoll Se, Warren, OH 44483 | 2018-11-27 |
| 1538656921 | Biswaraj Tharu | Student in an Organized Health Care Education/Training Program | 1350 East Market Street, Trumbull Regional Medical Cent, Warren, OH 44483 | 2018-04-20 |
| 1790216448 | Jeannie Gurich | Substance Abuse Rehabilitation Facility | 2737 Youngstown Warren Rd. Se, Warren, OH 44483 | 2017-03-24 |
| 1205388634 | Laurie L Horvath | Midwife | 1651 E Market, Warren, OH 44483 | 2016-11-02 |
| 1235586264 | Travis Robert Dickey | Physical Therapist | 4329 Mahoning Ave. Nw, Warren, OH 44483 | 2016-05-19 |
| Find all providers in zip 44483 | ||||
| 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 |
|---|---|---|---|---|
| 1679118236 | Good N Plenty Rx LLC | Pharmacy | 22260 Van Dyke Avenue, Warren, MI 48089 | 2019-11-07 |
| 1891337804 | Warren Family Pharmacy LLC | Pharmacy | 29156 Hoover Rd, Warren, MI 48093-3476 | 2019-10-10 |
| 1629532593 | Prestige Specialty Pharmacy 3 | Pharmacy | 31700 Van Dyke Ave Ste C, Warren, MI 48093-7949 | 2019-01-24 |
| 1871019422 | Highland Rx | Pharmacy | 26000 Hoover Rd Ste 107, Warren, MI 48089-1167 | 2017-08-16 |
| 1417472697 | Jp Pharmacy Inc. | Pharmacy | 27301 Schoenherr Rd Ste 106, Warren, MI 48088-6649 | 2017-08-08 |
| 1013431014 | Shah Alam Bhuiyan | Pharmacy | 24831 Ryan Rd, Warren, MI 48091-3390 | 2017-08-01 |
| 1427578483 | Elwaseem & Associates LLC | Pharmacy | 4208 E 9 Mile Rd, Warren, MI 48091-2578 | 2017-06-21 |
| 1952832990 | Genoa Healthcare, LLC | Pharmacy | 103 W Market St Ste P, Warren, OH 44481-1017 | 2017-03-22 |
| 1033667472 | Greater Care Pharmacy LLC | Pharmacy | 24800 Hoover Rd Ste B, Warren, MI 48089-1965 | 2016-09-14 |
| 1871913640 | Hoover Drugs LLC | Pharmacy | 28675 Hoover Rd, Warren, MI 48093-4152 | 2014-04-21 |
| Find all providers in WARREN | ||||
Please comment or provide details below to improve the information on CHAMPION DISCOUNT PHARMACY, LLC.
| 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.