PENNSYLVANIA CVS PHARMACY, L.L.C. (NPI# 1063516805) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063516805 |
| Entity Type | Organization |
| Organization Name | PENNSYLVANIA CVS PHARMACY, L.L.C. |
| Other Organization Name | CVS PHARMACY #01612 |
| Practice Address |
347 S Blakely St Dunmore PA 18512-2254 |
| Mailing Address |
1 Cvs Dr Po Box 1075 Woonsocket RI 02895-6146 |
| Practice Telephone | 5703429138 |
| Mailing Telephone | 4017651500 |
| Enumeration Date | 2006-09-12 |
| Last Update Date | 2012-03-08 |
| Authorized Official Name | SUSAN COLBERT (DIRECTOR PHCY ENROLLMENTS) |
| Authorized Official Telephone | 4017702751 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers | ||
| Y | 333600000X | Pharmacy | PP412101L | PA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OTHER ID NUMBER-COMMERCIAL NUMBER | 3940473 | 01 |
| Other Name | Type Code |
|---|---|
| CVS PHARMACY #01612 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174189294 | Pennsylvania Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 1717 N 12th St Unit F, Philadelphia, PA 19122-2585 | 2019-05-14 |
| 1750874517 | Pennsylvania Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 456 N 5th St, Philadelphia, PA 19123 | 2018-06-07 |
| 1972017671 | Pennsylvania Cvs Pharmacy, L.L.C. | Pharmacy | 141 West Lincoln Hwy, Exton, PA 19341 | 2017-11-17 |
| 1154833069 | Pennsylvania Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 1589 Fruitville Pike, Lancaster, PA 17601-4005 | 2017-11-01 |
| 1821513813 | Pennsylvania Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 2001 Pennsylvania Ave, Philadelphia, PA 19130-3823 | 2017-08-10 |
| 1497059463 | Pennsylvania Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 2363 Oregon Pike, Lancaster, PA 17601-4608 | 2011-01-05 |
| 1003118621 | Pennsylvania Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 445 West Street Rd., Warminster, PA 18974 | 2010-12-02 |
| 1790091668 | Pennsylvania Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 101 Oxford Valley Rd, Yardley, PA 19067 | 2010-08-30 |
| 1336451442 | Pennsylvania Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 2110 Spring Valley Rd, Lancaster, PA 17601-2427 | 2010-07-06 |
| 1730400953 | Pennsylvania Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 130 Schuylkill Rd, Phoenixville, PA 19460-2232 | 2010-06-22 |
| Street Address |
347 S BLAKELY ST |
| City | DUNMORE |
| State | PA |
| Zip Code | 18512-2254 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780854141 | Michelle Lee Jones | Pharmacist | 347 S Blakely St, Dunmore, PA 18512-2254 | 2008-03-01 |
| 1225207061 | George A. Kofel | Pharmacist | 347 S Blakely St, Dunmore, PA 18512-2254 | 2008-02-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730715822 | Suzette Jones | Nurse Practitioner | Mid-state Occupational Health Services, Inc., 1000 Meade Street, Dunmore, PA 18512 | 2020-03-20 |
| 1588175814 | Young Men's Christian Association of Greater Scranton | Health Educator | 706 North Blakely Street, Dunmore, PA 18512 | 2017-10-13 |
| 1033633763 | Kaitlyn Elizabeth Sledzinski | Occupational Therapist | 1000 Mill St., Dunmore, PA 18512 | 2017-08-03 |
| 1417366170 | Kristen Marie Miller | Social Worker | 502 North Blakely Street, Dunmore, PA 18512 | 2014-08-07 |
| 1689923799 | John Charles White | Social Worker | 502 Blakely St., Dunmore, PA 18512 | 2012-09-05 |
| 1043465594 | Anthony Harry Funaro | Radiology | 201 S. Blakely Street, Pmb - 197, Dunmore, PA 18512 | 2008-11-25 |
| 1932387602 | Maureen Judith Rebar | Social Worker | 32 Emerald Dr, Throop, PA 18512 | 2008-02-05 |
| 1316006398 | Frank Richard Padula | Dentist | 320 W Drinker St, Dunmore, PA 18512 | 2006-12-06 |
| 1366516163 | Peter W Shorten | Chiropractor | 115 W Drinker St, Dunmore, PA 18512 | 2006-11-20 |
| 1164592853 | Patricia Sweeney | Nurse Practitioner | 1208 O'neil Highway, Dunmore, PA 18512 | 2006-11-09 |
| Find all providers in zip 18512 | ||||
| Taxonomy Code | 333600000X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: added definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720358344 | Depietros Pharmacy LLC | Pharmacy | 617 3rd St, Dunmore, PA 18512-2849 | 2012-01-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811506561 | Temple Community Pharmacy | Pharmacy | 3535 N 5th Street Hwy Ste 2, Reading, PA 19605-1703 | 2020-07-29 |
| 1487262614 | Hometown Rx Services | Pharmacy | 3406 Edgmont Avenue, Suite B, Brookhaven, PA 19015 | 2020-07-14 |
| 1386269033 | San Juan Pharmacy LLC | Pharmacy | 200 W Buttonwood St, Reading, PA 19601-2603 | 2020-06-09 |
| 1831719319 | Mark Conklin | Pharmacy | 127 Greenbriar Dr, Wexford, PA 15090-7322 | 2020-04-24 |
| 1912536517 | Hsjc LLC | Pharmacy | 4165 N Franklin St, Philadelphia, PA 19140-2207 | 2020-04-06 |
| 1962036806 | Care Discount Pharmacy | Pharmacy | 5610 Derry St Ste 5, Harrisburg, PA 17111-3518 | 2020-03-01 |
| 1114564945 | Priority Care Rx LLC | Pharmacy | 127 S 5th St Ste 190, Quakertown, PA 18951-1674 | 2019-11-27 |
| 1326683707 | Vista Pharmacy LLC | Pharmacy | 938 N 8th St, Reading, PA 19604-2308 | 2019-11-09 |
| 1750926119 | Dharm Nandan LLC | Pharmacy | 3808 Morrell Ave, Philadelphia, PA 19114-1915 | 2019-11-08 |
| 1871137208 | My Philadelphia Pharmacy Inc | Pharmacy | 2901 E Thompson St, Front Store, Philadelphia, PA 19134 | 2019-10-29 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.