Provider Demographics
NPI:1730354291
Name:KLINGENSMITH'S DRUG STORES INC
Entity type:Organization
Organization Name:KLINGENSMITH'S DRUG STORES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:J
Authorized Official - Last Name:CIPPEL
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:724-763-2750
Mailing Address - Street 1:401 FORD ST FL 2
Mailing Address - Street 2:P.O. BOX 151
Mailing Address - City:FORD CITY
Mailing Address - State:PA
Mailing Address - Zip Code:16226-1229
Mailing Address - Country:US
Mailing Address - Phone:724-763-2750
Mailing Address - Fax:724-763-9257
Practice Address - Street 1:401 FORD ST FL 2
Practice Address - Street 2:
Practice Address - City:FORD CITY
Practice Address - State:PA
Practice Address - Zip Code:16226-1229
Practice Address - Country:US
Practice Address - Phone:724-763-2750
Practice Address - Fax:724-763-9257
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KLINGENSMITH'S DRUG STORES,INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-04-25
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0014756160001Medicaid
PA1007742930023Medicaid
PA1007742930010Medicaid
PA1007742930003Medicaid
PA1007742930017Medicaid
PA1007742930020Medicaid
PA1007742930026Medicaid
PA0014478270002Medicaid
PA0946270006Medicare NSC
PA1007742930026Medicaid
PA1231010001Medicare NSC
PA1232710001Medicare NSC
PA0946270002Medicare NSC
PA0946270005Medicare NSC
PA0946270007Medicare NSC
PA1007742930023Medicaid