PENN TRAFFIC CO (NPI# 1083635304) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083635304 |
| Entity Type | Organization |
| Organization Name | PENN TRAFFIC CO |
| Other Organization Name | BILO FOODS AND PHARMACY 9207 |
| Practice Address |
1305 E Main St Clarion PA 16214-1213 |
| Mailing Address |
1200 State Fair Blvd Syracuse NY 13209-1070 |
| Practice Telephone | 8142265808 |
| Practice Fax Number | 8142266284 |
| Mailing Telephone | 3154612600 |
| Mailing Fax Number | 3154612304 |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2008-06-13 |
| Authorized Official Name | JAMES ERBA (PHARMACY SYSTEMS MANAGER) |
| Authorized Official Telephone | 3154612595 |
| Authorized Official Credential | RPH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | PP415017L | PA | Suppliers |
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OTHER ID NUMBER-COMMERCIAL NUMBER | 3969788 | 01 | |
| PA | 01404006 | 05 | |
| PA PROMISE- MEDICAID | 1007783900044 | 01 |
| Other Name | Type Code |
|---|---|
| BILO FOODS AND PHARMACY 9207 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174544498 | Penn Traffic Co | Pharmacy | 40 S White St, Brookville, PA 15825-2422 | 2006-07-21 |
| 1629099940 | Penn Traffic Co | Pharmacy | 100 N Main St, Du Bois, PA 15801-1888 | 2006-07-21 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Vermont Business Registrations | PENN TRAFFIC COMPANY THE | Po Box 4737, Syracuse, NY 13221 |
| Street Address |
1305 E MAIN ST |
| City | CLARION |
| State | PA |
| Zip Code | 16214-1213 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417555616 | Dubois Regional Medical Center | Pharmacy | 265 Holiday Inn Drive Route 68, Clarion, PA 16214 | 2020-10-12 |
| 1699239657 | Clarion Rehabilitation and Aquatic Therapy LLC | Clinic/Center | 499 Mayfield Rd, Office 134, Clarion, PA 16214 | 2019-01-24 |
| 1912409491 | Jason Noto | Psychologist | 800 Boundary St., Clarion, PA 16214 | 2018-03-01 |
| 1265874226 | Devin Michael Ellery Skinner | Specialist/Technologist | 112 Tippin Gym, Clarion University, Clarion, PA 16214 | 2013-07-19 |
| 1952650152 | Adam Clarke | Psychologist | 1200 Eastwood Dr Ste 2, Clarion, PA 16214 | 2012-09-04 |
| 1730386590 | Betty E Mckisson | Registered Nurse | 162 S 7th Ave, Applewood Center, Clarion, PA 16214 | 2007-06-27 |
| 1902011471 | Melissa Kae Riley | Chiropractor | 44 N 1st Avenue., Suite B, Clarion, PA 16214 | 2007-05-10 |
| 1669506002 | Christina E Vanepps | Student in an Organized Health Care Education/Training Program | 214 South 7thave, Clarion, PA 16214 | 2007-03-16 |
| 1649304098 | Erin D Monrean | Student in an Organized Health Care Education/Training Program | 214 South 7th Ave, Clarion, PA 16214 | 2007-03-16 |
| 1730218397 | Jean J Troese | Student in an Organized Health Care Education/Training Program | 215 South 7th Ave, Clarion, PA 16214 | 2007-03-02 |
| Find all providers in zip 16214 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| 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. |
| 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: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417555616 | Dubois Regional Medical Center | Pharmacy | 265 Holiday Inn Drive Route 68, Clarion, PA 16214 | 2020-10-12 |
| 1386719748 | Iowa Specialty Hospital - Clarion | Pharmacy | 215 13th Ave Sw, Clarion, IA 50525-2078 | 2006-11-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376143990 | Valerie Hellriegel | Pharmacy | 567 N Route 100, Bechtelsville, PA 19505-9263 | 2020-11-01 |
| 1134729791 | John P Russo | Pharmacy | 608 E Hillcrest Ave, New Castle, PA 16105-2254 | 2020-10-31 |
| 1538769864 | Luzerne Discount Pharmacy Inc | Pharmacy | 101 Main St Unit D, Luzerne, PA 18709-1209 | 2020-10-27 |
| 1780290197 | Weis Markets, Inc. | Pharmacy | 112 Atlantic Ave., Dingmans Ferry, PA 18328 | 2020-09-21 |
| 1275146177 | Newport Pharmacy LLC | Pharmacy | 57 S 2nd St, Newport, PA 17074-1402 | 2020-08-28 |
| 1699387779 | Allegheny Valley Hospital Retail Pharmacy | Pharmacy | 1301 Carlisle St Fl 3, Natrona Heights, PA 15065-1152 | 2020-08-19 |
| 1396355426 | Mdk Health | Pharmacy | 3985 Columbia Ave Unit 2, Columbia, PA 17512-9003 | 2020-08-04 |
| 1861000861 | Koso,llc | Pharmacy | 407 Shadeland Ave, Drexel Hill, PA 19026-1437 | 2020-07-16 |
| 1184241408 | Roosevelt Pharmacy LLC | Pharmacy | 2600 Cottman Ave, Philadelphia, PA 19149-1301 | 2020-07-02 |
| 1780201178 | Penn Jones Inc | Pharmacy | 611 Centre St, Freeland, PA 18224-1941 | 2020-07-01 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on PENN TRAFFIC CO.
| 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.