NPIMap

Organization Active NPI

Penn Traffic Company, the

  • Pharmacy
  • Syracuse, NY
National Provider Identifier
1023281540
Registry record updated Apr 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
Legal business name
PENN TRAFFIC COMPANY, THE
Practice address
1200 State Fair Blvd
Syracuse, NY 13209-1070
Phone
(315) 461-2600
Fax
(315) 461-2304
NPI assigned
Apr 4, 2008
Last updated
Apr 4, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2008

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

Authorized official

Name
Mr. Daniel J. Mahoney, J.D.
Title
Vice President/Corproate Council
Phone
(315) 461-2347

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X Primary

Addresses

Primary practice location

1200 State Fair Blvd
Syracuse, NY 13209-1070

Mailing address

1200 State Fair Blvd
Syracuse, NY 13209-1070
Phone (315) 461-2600

Other identifiers 4

IdentifierTypeStateIssuer
454OtherNCPDP CHAIN CODE
452OtherNCPCP CHAIN CODE
993OtherNCPDP FRANCHISE CODE
449OtherNCPDP CHAIN CODE

National Provider Directory

National Provider Directory
Tax ID family
Bilo Foods and Pharmacy 920711 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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

NPI Registry JSON

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

{
    "created_epoch": "1207267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207267200000",
    "number": "1023281540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 STATE FAIR BLVD",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132091070",
            "telephone_number": "315-461-2600",
            "fax_number": "315-461-2304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 STATE FAIR BLVD",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132091070",
            "telephone_number": "315-461-2600",
            "fax_number": "315-461-2304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENN TRAFFIC COMPANY, THE",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-04",
        "last_updated": "2008-04-04",
        "status": "A",
        "authorized_official_last_name": "MAHONEY",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "VICE PRESIDENT/CORPROATE COUNCIL",
        "authorized_official_telephone_number": "315-461-2347",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "J.D."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP CHAIN CODE",
            "identifier": "454",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPCP CHAIN CODE",
            "identifier": "452",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP FRANCHISE CODE",
            "identifier": "993",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP CHAIN CODE",
            "identifier": "449",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2008; 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.