Old Baltimore Pike Apothecary Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PP410390L Issued in PA

Legal business name

OLD BALTIMORE PIKE APOTHECARY INC

Doing business as

Southern Chester County Pharmacy

Practice address

1011 W Baltimore Pike
Ste 109
West Grove, PA 19390-9446

Phone

(610) 869-3200

Fax

(610) 869-4221

NPI assigned

Jun 15, 2006

Organization subpart

No

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

Authorized official

Name

Alfred Gagliardi, RPH

Title

Owner

Phone

(610) 869-3200

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• SOUTHERN CHESTER COUNTY PHARMACY Doing business as

Medicare fee-for-service enrollment

Enrolled in PA2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Medicare medical equipment & supply locations

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Alfonse Gagliardi, R.P.H.

  • Pharmacist
  • West Grove, PA
  • NPI 1700833779
  NPD (past)

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1471564800000",
    "number": "1124062088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 W BALTIMORE PIKE",
            "address_2": "STE 109",
            "city": "WEST GROVE",
            "state": "PA",
            "postal_code": "193909446",
            "telephone_number": "610-869-3200",
            "fax_number": "610-869-4221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 W BALTIMORE PIKE",
            "address_2": "STE 109",
            "city": "WEST GROVE",
            "state": "PA",
            "postal_code": "193909446",
            "telephone_number": "610-869-3200",
            "fax_number": "610-869-4221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLD BALTIMORE PIKE APOTHECARY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-15",
        "last_updated": "2016-08-19",
        "status": "A",
        "authorized_official_last_name": "GAGLIARDI",
        "authorized_official_first_name": "ALFRED",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "610-869-3200",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "PA",
            "license": "PP410390L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000936826",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2084252",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SOUTHERN CHESTER COUNTY PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Stephen Naylor, DO
• Theresa A Noone, CNM
• Mark S. Noveck, MD
• Aidan Manley O'Brien
• Michael O'Donnell
• Melinda Olivencia-Lozada
• David Ong, P.T.
• Mary-Anne Ost, M.D.
• Arpita Patel, PT
• Philip G Patt, M.D.

• Community/Retail Pharmacy in West Grove, PA
• Providers in West Grove, PA by specialty
• Community/Retail Pharmacy in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.