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HERMITAGE PHARMACY LLC
NPI 1407949852
Pharmacy - Community/Retail Pharmacy in Hermitage, PA

Active since September 30, 2006CLIA 39D2210802 · Waiver
1740 E STATE ST, HERMITAGE, PA 16148(724) 983-8451(724) 983-0918 Get Directions Write a Review

NPPES record last updated: October 20, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Hermitage Pharmacy Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

HERMITAGE PHARMACY LLC (NPI 1407949852), doing business as Hermitage Pharmacy, is a healthcare organization registered as a community/retail pharmacy in Hermitage, Pennsylvania and active in the NPI registry since September 2006. The organization holds a CLIA Waiver certificate valid through January 24, 2027 and lists Bretton Clark Walberg, Member, as its authorized official.

NPPES Registry Identity

NPI1407949852
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameHERMITAGE PHARMACY LLC
Location Address1740 E STATE STHermitage, PA 16148-1862
Mailing Address30 Conneaut Lake RoadGreenville, PA 16125-2167 · (724) 612-2131 · Fax (724) 983-0918
Phone(724) 983-8451
Fax(724) 983-0918
Organization SubpartNo
Authorized OfficialBretton Clark WalbergMember · (724) 612-2131
Enumeration DateSeptember 30, 2006
Last NPPES UpdateOctober 20, 2025
NPPES CertifiedOctober 20, 2025
✔ NPI 1407949852 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers
Taxonomy Code3336C0003X
License✔ Licensed in PA · PP412447L
Definition
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.
Also ListedDurable Medical Equipment & Medical SuppliesTaxonomy 332B00000X
Also ListedPharmacyTaxonomy 333600000X
Also ListedPharmacy · Specialty PharmacyTaxonomy 3336S0011X
1740 E STATE ST, Hermitage, PA 16148
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Other Names 2

Doing Business AsHermitage Pharmacy
Doing Business AsThe Medicine Shoppe Pharmacy

Other Identifiers 3

Medicaid104547785-0001PA
Other2083437Pk
Medicaid1023278440002PA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter from Arizona Complete Health and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 39D2210802

Hermitage Pharmacy · Hermitage, PA
Active · expires Jan 24, 2027
CLIA Number39D2210802
Laboratory TypeHospital
Certificate Effective DateJanuary 25, 2025
Certificate Expiration DateJanuary 24, 2027
Laboratory DirectorMatthew S. Shellenbarger
Laboratory Phone(724) 983-8451
Laboratory LocationHermitage Pharmacy1740 E State St, Hermitage, PA 16148
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Administration of influenza virus vaccine G0008
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
22 services22 patients
Influenza vaccine, inactivated 90653
The Influenza vaccine, inactivated, is a shot given to protect against the flu. It contains killed virus particles that help your body build immunity to the flu. It's recommended annually to keep your protection up-to-date. It's safe for ages 6 months and up.
16 services16 patients

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DONNA GARLAND
Pharmacist
1740 E STATE ST
HERMITAGE, PA 16148
Mercer County (724) 983-8451
RHONDA M YARZAB
Pharmacist
1740 E STATE ST
HERMITAGE, PA 16148
Mercer County (724) 983-8451
DR. DEVON MARIE YOKUBEAK PHARMD
Pharmacist
1740 E STATE ST
HERMITAGE, PA 16148
Mercer County (724) 983-8451
PAUL SCOTT VAUGHN RPH
Pharmacist
1740 E STATE ST
HERMITAGE, PA 16148
Mercer County (724) 983-8451

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Hermitage Pharmacy LLC's NPI number?

The NPI number for Hermitage Pharmacy LLC is 1407949852. It was assigned to this organization in the NPPES registry on September 30, 2006. The provider is doing business as Hermitage Pharmacy and The Medicine Shoppe Pharmacy.

Where is Hermitage Pharmacy LLC located?

Hermitage Pharmacy LLC is located at 1740 E State St, Hermitage, PA 16148. The listed phone number is (724) 983-8451.

What is Hermitage Pharmacy LLC's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Community/Retail Pharmacy, with taxonomy code 3336C0003X.

Does Hermitage Pharmacy LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 39D2210802) is associated with this NPI, valid through January 24, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Hermitage Pharmacy LLC accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter Health of Delaware, Ambetter from Absolute Total Care and Ambetter from Arizona Complete Health and 46 other insurers list Hermitage Pharmacy LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Hermitage Pharmacy LLC was last updated on October 20, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.