NPIMap

Organization Active NPI

Spartan Pharmacy Inc

Doing business as Spartan Pharmacy

  • Community/Retail Pharmacy
  • Bethel Park, PA
National Provider Identifier
1124116298
Registry record updated Aug 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PP411714L Issued in PA
Legal business name
SPARTAN PHARMACY INC
Doing business as
Spartan Pharmacy
Practice address
3400 S Park Rd
Bethel Park, PA 15102-1150
Phone
(412) 831-1333
Fax
(412) 831-1991
NPI assigned
Oct 11, 2006
Organization subpart
Yes
Parent organization
SPARTAN PHARMACY INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 24, 2021

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

Authorized official

Name
Mr. Adam Rice, PHARMACIST
Title
Owner
Phone
(412) 884-5650

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X PP411714L PA Primary

Addresses

Primary practice location

3400 S Park Rd
Bethel Park, PA 15102-1150

Mailing address

3400 South Park Rd
Bethel Park, PA 15102
Phone (412) 831-1333

Other names 1

  • Spartan 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
O20111212000846 PA Part B Supplier - Mass Immunization (Roster Biller Only) 5092994343 2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Brentwood, PA; Pittsburgh, PA; Bethel Park, PA
O20241121000237 PA DME Supplier - Pharmacy 5092994343 Practice locations: Bethel Park, PA

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Spartan Pharmacy Inc8 organizations share this tax ID, including this one
Part of
Spartan Pharmacy Inc

Other organizations with this tax ID 7

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

NPI Registry JSON

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629763200000",
    "number": "1124116298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 SOUTH PARK RD",
            "city": "BETHEL PARK",
            "state": "PA",
            "postal_code": "15102",
            "telephone_number": "412-831-1333",
            "fax_number": "412-831-1991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 S PARK RD",
            "city": "BETHEL PARK",
            "state": "PA",
            "postal_code": "151021150",
            "telephone_number": "412-831-1333",
            "fax_number": "412-831-1991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPARTAN PHARMACY INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SPARTAN PHARMACY INC",
        "enumeration_date": "2006-10-11",
        "last_updated": "2021-08-24",
        "certification_date": "2021-08-24",
        "status": "A",
        "authorized_official_last_name": "RICE",
        "authorized_official_first_name": "ADAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "412-884-5650",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PHARMACIST"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "PA",
            "license": "PP411714L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Spartan Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Spartan Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bethel Park, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2021; 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.