NPIMap

Organization Active NPI

Community Health Net

  • Community/Retail Pharmacy
  • Erie, PA
National Provider Identifier
1093026510
Registry record updated Apr 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PP481962 Issued in PA
Legal business name
COMMUNITY HEALTH NET
Practice address
1202 State St
Erie, PA 16501-1914
Phone
(814) 464-9520
Fax
(814) 464-9585
NPI assigned
Jun 30, 2010
Last updated
Apr 21, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2023

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

Authorized official

Name
Craig A Ulmer
Title
Ceo
Phone
(814) 454-4530

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X PP481962 PA Primary

Addresses

Primary practice location

1202 State St
Erie, PA 16501-1914

Mailing address

PO Box 369
Erie, PA 16512-0369
Phone (814) 455-7222

Other identifiers 2

IdentifierTypeStateIssuer
1007543070050MedicaidPA
2125759OtherPK

Other names 1

  • Community Health Net Pharmacy Other name

National Provider Directory

National Provider Directory
Tax ID family
Community Health Net6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Locations

1202 State St
Erie, PA 16501
Phone (814) 454-4530

NPI Registry JSON

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

{
    "created_epoch": "1277856000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682035200000",
    "number": "1093026510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 369",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165120369",
            "telephone_number": "814-455-7222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1202 STATE ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165011914",
            "telephone_number": "814-464-9520",
            "fax_number": "814-464-9585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY HEALTH NET",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-30",
        "last_updated": "2023-04-21",
        "certification_date": "2023-04-21",
        "status": "A",
        "authorized_official_last_name": "ULMER",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "814-454-4530"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "PA",
            "license": "PP481962",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007543070050",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2125759",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Community Health Net Pharmacy",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Erie, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2023; 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.