Organization Active NPI

Johnson's Pharmacy of Conyngham, Inc

  • Pharmacy
  • Conyngham, PA
National Provider Identifier
1003531773
Registry record updated Oct 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
Legal business name
JOHNSON'S PHARMACY OF CONYNGHAM, INC
Practice address
345 Main Street
Conyngham, PA 18219
Phone
(570) 650-5639
NPI assigned
Oct 5, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2022

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

Authorized official

Name
Robert Hinkle
Title
Owner
Phone
(570) 650-5639

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X Primary

Addresses

Primary practice location

345 Main Street
Conyngham, PA 18219

Mailing address

345 Main Street
Conyngham, PA 18219
Phone (570) 650-5639

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241204004416 PA Part B Supplier - Pharmacy 8022544733 Practice locations: Conyngham, PA

National Provider Directory

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.

NPI Registry JSON

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

{
    "created_epoch": "1664928000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664928000000",
    "number": "1003531773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "345 MAIN STREET",
            "city": "CONYNGHAM",
            "state": "PA",
            "postal_code": "18219",
            "telephone_number": "570-650-5639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 MAIN STREET",
            "city": "CONYNGHAM",
            "state": "PA",
            "postal_code": "18219",
            "telephone_number": "570-650-5639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHNSON'S PHARMACY OF CONYNGHAM, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-05",
        "last_updated": "2022-10-05",
        "certification_date": "2022-10-04",
        "status": "A",
        "authorized_official_last_name": "HINKLE",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "570-650-5639"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conyngham, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.