Organization Active NPI

CCN America LP

Doing business as Coordinated Care Network Pharmacy

  • Community/Retail Pharmacy
  • Pittsburgh, PA
National Provider Identifier
1114004082
Registry record updated Sep 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
114317 Issued in AL
Legal business name
CCN AMERICA LP
Doing business as
Coordinated Care Network Pharmacy
Practice address
300 Penn Center Blvd
Ste 405
Pittsburgh, PA 15235-5511
Phone
(412) 349-6337
Fax
(412) 349-6311
NPI assigned
Oct 31, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2025

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

Authorized official

Name
Thomas Pollack
Title
President and Cfo
Phone
(412) 349-6300

Specialties & licenses 15

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 054.018830 IL
Community/Retail Pharmacy 3336C0003X PHNR000903 GA
Community/Retail Pharmacy 3336C0003X MO40001734 ME
Community/Retail Pharmacy 3336C0003X PA1463 KY
Community/Retail Pharmacy 3336C0003X 4388 IA
Community/Retail Pharmacy 3336C0003X 114317 AL Primary
Community/Retail Pharmacy 3336C0003X 13674 MS
Community/Retail Pharmacy 3336C0003X 264536 MN
Community/Retail Pharmacy 3336C0003X 64001140A IN
Community/Retail Pharmacy 3336C0003X 2013028515 MO
Community/Retail Pharmacy 3336C0003X 22-13060 KS
Community/Retail Pharmacy 3336C0003X 92900 FL
Community/Retail Pharmacy 3336C0003X 5301010585 MI
Community/Retail Pharmacy 3336C0003X P07388 MD
Community/Retail Pharmacy 3336C0003X A9-0001443 DE

Addresses

Primary practice location

300 Penn Center Blvd
Ste 405
Pittsburgh, PA 15235-5511

Mailing address

PO Box 5000
Greensburg, PA 15601-2117
Phone (412) 349-6300

Other identifiers 10

IdentifierTypeStateIssuer
0235504MedicaidNJ
1114004082MedicaidMN
2085919OtherPK
2016006960MedicaidVA
1018103020001MedicaidPA
2721540MedicaidOH
3810008615MedicaidWV
1114004082MedicaidIL
7100147740MedicaidKY
300012108MedicaidIN

Other names 1

  • Coordinated Care Network 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
O20100930067993 PA DME Supplier - Pharmacy 7214131689 Practice locations: Pittsburgh, PA
O20221228000233 PA Part B Supplier - Pharmacy 7214131689 Practice locations: Pittsburgh, PA

National Provider Directory

National Provider Directory
Tax ID family
CCN America LP7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Locations

1500 W Cypress Creek Rd
Ste 203
Fort Lauderdale, FL 33309
Phone (877) 349-6337

NPI Registry JSON

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

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758240000000",
    "number": "1114004082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5000",
            "city": "GREENSBURG",
            "state": "PA",
            "postal_code": "156012117",
            "telephone_number": "412-349-6300",
            "fax_number": "412-349-6311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 PENN CENTER BLVD",
            "address_2": "STE 405",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152355511",
            "telephone_number": "412-349-6337",
            "fax_number": "412-349-6311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CCN AMERICA LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-31",
        "last_updated": "2025-09-19",
        "status": "A",
        "authorized_official_last_name": "POLLACK",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "PRESIDENT AND CFO",
        "authorized_official_telephone_number": "412-349-6300"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "IL",
            "license": "054.018830",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "GA",
            "license": "PHNR000903",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "ME",
            "license": "MO40001734",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "KY",
            "license": "PA1463",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "IA",
            "license": "4388",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "AL",
            "license": "114317",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MS",
            "license": "13674",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MN",
            "license": "264536",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "IN",
            "license": "64001140A",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MO",
            "license": "2013028515",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "KS",
            "license": "22-13060",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "FL",
            "license": "92900",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MI",
            "license": "5301010585",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MD",
            "license": "P07388",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "DE",
            "license": "A9-0001443",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0235504",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1114004082",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2085919",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2016006960",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1018103020001",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2721540",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810008615",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1114004082",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100147740",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300012108",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Coordinated Care Network Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Coordinated Care Network 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 Sep 19, 2025; 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.