# MANTUA PHARMACY INC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** MANTUA STATION DRUG CO.
- **Organization subpart:** No

## Provider details

- **NPI number:** 1063565927
- **Authorized official:** MR. STEVEN R WIGGERS RPH (OWNER)
- **Authorized official phone:** (330) 274-2209

## Contact information

- **Practice address:** 10870 N. MAIN ST, MANTUA, OH 44255
- **Practice address phone:** (330) 274-2209
- **Practice address fax:** (330) 274-5220
- **Mailing address:** 10870 N. MAIN ST, PO BOX 777, MANTUA, OH 44255
- **Mailing address phone:** (330) 274-2209
- **Mailing address fax:** (330) 274-5220

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 01/22/2007
- **Last updated:** 05/17/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 5492800 | — | OH |