Organization Active NPI

Doral Pharmaceuticals LLC

Doing business as Kevin's Shop n Save Pharmacy

  • Community/Retail Pharmacy
  • Pittsburgh, PA
National Provider Identifier
1013938075
Registry record updated Nov 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PP415072L Issued in PA
Legal business name
DORAL PHARMACEUTICALS LLC
Doing business as
Kevin's Shop n Save Pharmacy
Practice address
799 Castle Shannon Blvd
Pittsburgh, PA 15234-1601
Phone
(412) 561-2417
Fax
(412) 561-7418
NPI assigned
Jul 22, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2023

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

Authorized official

Name
Prudence Evancic
Title
President
Phone
(412) 561-2417

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X PP415072L PA Primary

Addresses

Primary practice location

799 Castle Shannon Blvd
Pittsburgh, PA 15234-1601

Mailing address

799 Castle Shannon Blvd
Pittsburgh, PA 15234-1601
Phone (412) 561-2417

Other identifiers 2

IdentifierTypeStateIssuer
101647428001MedicaidPA
2083965OtherPK

Other names 1

  • Kevin's Shop n Save Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20140415001353 PA Part B Supplier - Mass Immunization (Roster Biller Only) 3375775810 Practice locations: Pittsburgh, PA
O20230724000312 PA DME Supplier - Pharmacy 3375775810 Practice locations: Pittsburgh, PA

National Provider Directory

National Provider Directory
Tax ID family
Doral Pharmaceuticals LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

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": "1153526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1700179200000",
    "number": "1013938075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "799 CASTLE SHANNON BLVD",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152341601",
            "telephone_number": "412-561-2417",
            "fax_number": "412-561-7418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "799 CASTLE SHANNON BLVD",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152341601",
            "telephone_number": "412-561-2417",
            "fax_number": "412-561-7418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DORAL PHARMACEUTICALS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-22",
        "last_updated": "2023-11-17",
        "certification_date": "2023-11-17",
        "status": "A",
        "authorized_official_last_name": "EVANCIC",
        "authorized_official_first_name": "PRUDENCE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "412-561-2417"
    },
    "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": "PP415072L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101647428001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2083965",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kevin's Shop n Save Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pittsburgh, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2023; 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.