# MINERVA PHARMACY INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** The Medicine Shoppe
- **Organization subpart:** No

## Provider details

- **NPI number:** 1295826741
- **Authorized official:** MRS. ANDREA EVANICH R PH (PHARMACIST)
- **Authorized official phone:** (330) 453-4804

## Contact information

- **Practice address:** 251 EAST ST, MINERVA, OH 44657-1617
- **Practice address phone:** (330) 868-6200
- **Practice address fax:** (330) 453-7688
- **Mailing address:** 2601 TUSCARAWAS ST W, CANTON, OH 44708-4603
- **Mailing address phone:** (330) 453-4804
- **Mailing address fax:** (330) 453-7688

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | 03-2-19719 | OH | — |
| 3336C0003X | Community/Retail Pharmacy | 03-2-19719 | OH | Yes |

## Other

- **Enumeration date:** 09/28/2006
- **Last updated:** 12/17/2007

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0853901 | — | OH |
| 01 | — | 3656292 | NAPB | OH |