ProMedica Outpatient Pharmacy – Community/Retail Pharmacy, NPI 1740217678
Community/Retail Pharmacy
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for ProMedica Outpatient Pharmacy
PO BOX 636599
CINCINNATI, OH 452636599
Phone: (419) 291-5418
Fax: (419) 479-6927
Type: Mailing
3142 W CENTRAL AVE
TOLEDO, OH 436062920
Phone: (419) 291-4496
Fax: (419) 214-4350
Type: Mailing
2100 W. CENTRAL AVE
STE 140
TOLEDO, OH 43606
Phone: (419) 291-4496
Fax: (419) 214-4350
Type: Mailing
ProMedica Toledo Hospital, 2142, North Cove Boulevard, Toledo, Lucas County, Ohio, 43606, United States
TOLEDO, OH 436063895
Phone: (419) 291-5418
Fax: (419) 479-6927
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2024-09-30 (617 days ago).
Enrollment records
1
Earliest due date
2024-09-30
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20110322000066 | O | Pharmacy | OH | 2024-09-30 |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 45263)
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