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Contact Information

OVERHOLTS CHAMPION PHARMACY INC.
4619 MAHONING AVE.
WARREN, OH44483
 Phone: 330-847-8000
 Fax: 330-847-7708
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community/Retail Pharmacy

3336C0003X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for OVERHOLTS CHAMPION PHARMACY INC.

NPI # 1730273491
LBN Legal business name OVERHOLTS CHAMPION PHARMACY INC.
Authorized official KENNETH OVERHOLT - (PRESIDENT/CHIEF PHARMACIST)
Entity Organization
Organization subpart 1 No
Enumeration date 10/03/2006
Last updated 08/22/2020 - About 6 years ago
Identifiers
OH License # 02649200
OH Medicaid 0827118
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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