WANDAROO INC NPI 1376167908

NPI Information

  • NPI: 1376167908
  • Provider Name: WANDAROO INC
  • Classification: Pharmacy - 3336L0003X
  • Specialization: Long Term Care Pharmacy
  • Entity Type: Organization
  • Doing Business As: THE HOMETOWN PHARMACY LONG TERM CARE
  • CLIA Number: 36D2183811
  • Address: 1135 W WESTERN RESERVE RD
    POLAND, OH
    ZIP 44514
  • Phone: (330) 629-7345

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NPI Details

WANDAROO INC is a long term care pharmacy pharmacy in Poland, OH. The provider is a pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements. WANDAROO INC NPI is 1376167908. The provider is registered as an organization entity type.
The provider Is Doing Business As The Hometown Pharmacy Long Term Care.

The provider's business location address is:

1135 W WESTERN RESERVE RD
POLAND, OH
ZIP 44514-592
Phone: (330) 629-7345
Fax: (330) 629-7353

The provider's authorized official is Ronald T Mcdermott .
The authorized official title is Svp Operations and has the following contact phone number (330) 318-3926.

The CLIA number assigned to this NPI record is 36D2183811 - pharmacy with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/29/2020 and was last updated on 8/4/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
13336L0003XPharmacyLong Term Care PharmacyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
12960005MEDICAIDOHIO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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