Willits Road Pharmacy Inc

Primary specialty

PharmacistTaxonomy code 183500000X

License

PP415332L Issued in PA

Legal business name

WILLITS ROAD PHARMACY INC

Doing business as

Willits Road Pharmacy

Practice address

3122-24 Willits Road
Philadelphia, PA 19136-1116

Phone

(215) 673-9909

Fax

(215) 673-3824

NPI assigned

Feb 15, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Michael James Cavanaugh, RPH

Title

Vice President

Phone

(215) 673-9909

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Willits Road Pharmacy Doing business as

Locations

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

{
    "created_epoch": "1139961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1287705600000",
    "number": "1083688246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3122-24 WILLITS ROAD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191361116",
            "telephone_number": "215-673-9909",
            "fax_number": "215-673-3824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3122-24 WILLITS ROAD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191361116",
            "telephone_number": "215-673-9909",
            "fax_number": "215-673-3824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLITS ROAD PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-15",
        "last_updated": "2010-10-22",
        "status": "A",
        "authorized_official_last_name": "CAVANAUGH",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "215-673-9909",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist",
            "state": "PA",
            "license": "PP415332L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001664883",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Willits Road Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Pharmacist in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Pharmacist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2010; 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.