Individual provider Active NPI

Robert Flannelly, RPH

  • Pharmacist
  • Stroudsburg, PA
National Provider Identifier
1104299205
Registry record updated Apr 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RP032713L Issued in PA
Practice address
1148 W Main St
Suite 2
Stroudsburg, PA 18360-1323
Phone
(941) 350-0446
NPI assigned
Nov 11, 2015
Last updated
Apr 26, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 26, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RP032713L PA Primary

Addresses

Primary practice location

1148 W Main St
Suite 2
Stroudsburg, PA 18360-1323

Mailing address

1148 W Main St
Suite 2
Stroudsburg, PA 18360-1323
Phone (941) 350-0446

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
RP032713LPAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Airwaze LLC Current Accepting new patients
Bridge Healthcare Current Accepting new patients
Gaboro Medical Supply Current Accepting new patients
Dischargers LLC Past Accepting new patients

Locations

140 N 2nd St
Unit 3
Stroudsburg, PA 18360

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1447200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650931200000",
    "number": "1104299205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1148 W MAIN ST",
            "address_2": "SUITE 2",
            "city": "STROUDSBURG",
            "state": "PA",
            "postal_code": "183601323",
            "telephone_number": "941-350-0446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1148 W MAIN ST",
            "address_2": "SUITE 2",
            "city": "STROUDSBURG",
            "state": "PA",
            "postal_code": "183601323",
            "telephone_number": "941-350-0446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLANNELLY",
        "first_name": "ROBERT",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-11-11",
        "last_updated": "2022-04-26",
        "certification_date": "2022-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "PA",
            "license": "RP032713L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stroudsburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2022; 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.