NPIMap

Organization Active NPI

CCN America LP

Doing business as Coordinated Care Network Pharmacy

  • Community/Retail Pharmacy
  • Philadelphia, PA
National Provider Identifier
1003214214
Registry record updated Feb 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PP482532 Issued in PA
Legal business name
CCN AMERICA LP
Doing business as
Coordinated Care Network Pharmacy
Practice address
249 S 13TH St
Philadelphia, PA 19107-5640
Phone
(844) 657-6786
Fax
(267) 324-3594
NPI assigned
Dec 22, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Thomas Pollack
Title
President and Cfo
Phone
(412) 349-6300

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X PP482532 PA Primary

Addresses

Primary practice location

249 S 13TH St
Philadelphia, PA 19107-5640

Mailing address

300 Penn Center Blvd
Suite 505
Pittsburgh, PA 15235-5511
Phone (412) 349-6300

Other identifiers 2

IdentifierTypeStateIssuer
1018103020002MedicaidPA
2149363OtherPK

Other names 1

  • Coordinated Care Network Pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
CCN America LP7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1419206400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645660800000",
    "number": "1003214214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 PENN CENTER BLVD",
            "address_2": "SUITE 505",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152355511",
            "telephone_number": "412-349-6300",
            "fax_number": "412-349-6724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "249 S 13TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191075640",
            "telephone_number": "844-657-6786",
            "fax_number": "267-324-3594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CCN AMERICA LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-22",
        "last_updated": "2022-02-24",
        "certification_date": "2022-02-24",
        "status": "A",
        "authorized_official_last_name": "POLLACK",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "PRESIDENT AND CFO",
        "authorized_official_telephone_number": "412-349-6300"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "PA",
            "license": "PP482532",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1018103020002",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2149363",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Coordinated Care Network Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Coordinated Care Network Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.