Individual provider Active NPI

Rosa Lee, PHARM.D.

  • Pharmacist
  • Philadelphia, PA
National Provider Identifier
1124639166
Registry record updated Feb 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RP454808 Issued in PA
Practice address
1117 Walnut St
Philadelphia, PA 19107-4965
Phone
(215) 627-2143
Fax
(215) 627-8943
NPI assigned
Aug 13, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 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 RP454808 PA Primary

Addresses

Primary practice location

1117 Walnut St
Philadelphia, PA 19107-4965

Mailing address

102 Antler CT
Fairless Hills, PA 19030-3706
Phone (215) 765-9332

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
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
RP454808PAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Procare Pharmacy, L.L.C. CurrentSince Feb 24, 2022 Accepting new patients
Procare Pharmacy, LLC. PastSince Feb 24, 2022 Accepting new patients
Rite Aid of Pennsylvania LLC PastSince Aug 1, 2020 Accepting new patients
Rite Aid of Pennsylvania LLC PastSince Aug 1, 2020 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1597276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644796800000",
    "number": "1124639166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 ANTLER CT",
            "city": "FAIRLESS HILLS",
            "state": "PA",
            "postal_code": "190303706",
            "telephone_number": "215-765-9332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1117 WALNUT ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074965",
            "telephone_number": "215-627-2143",
            "fax_number": "215-627-8943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "ROSA",
        "credential": "PHARM.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-13",
        "last_updated": "2022-02-14",
        "certification_date": "2022-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "PA",
            "license": "RP454808",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 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.